How Much Do You Know About Health Reform?

There are many misconceptions about the Affordable Care Act—the health reform legislation signed into law by President Barack Obama on March 23, 2010. Separate fact from fiction with the quiz below.

1. • True or False: The Affordable Care Act will reduce private insurance coverage in the United States.
   • True
   • False

     In fact, private insurance coverage rises dramatically under the Affordable Care Act. The Census Bureau estimates that 60 percent of Americans have private health care coverage through their employer. Under the Affordable Care Act, these individuals may keep their private health insurance. Additionally, the Affordable Care Act extends private coverage to those who could otherwise be uninsured, such as individuals with pre-existing conditions and young adults.

     Bureau of the Census, “Income, Poverty, and Health Insurance Coverage in the United States: 2007” (Department of Commerce, 2008). https://www.census.gov/prod/2008pubs/p60-235.pdf

2. • True or False: The Affordable Care Act will end the ability of insurance companies to exclude pre-existing medical conditions from coverage.
   • True

     The Affordable Care Act ensures that private insurance companies will not be allowed to deny coverage to any individual because they have a pre-existing condition, like cancer or diabetes, in 2014 and beyond. To help those with pre-existing conditions access needed care immediately, Congress created the temporary Pre-Existing Condition Insurance Plan, which 40,000 Americans have already enrolled in.

     U.S. Department of Health and Human Services, “HHS to Reduce Premiums, Make it Easier for Americans with Pre-Existing Conditions to Get Health Insurance,” Press release, May 31, 2011. https://www.hhs.gov/news/press/2011pres/05/20110531b.html

     U.S. Department of Health and Human Services, “State by State Enrollment in the Pre-Existing Condition Insurance Plan, as of October 31, 2011,” Press release, October 31, 2011. https://www.healthcare.gov/news/factsheets/2011/12/pcip12092011a.html

   • False
3. • According to the nonpartisan Congressional Budget Office, the Affordable Care Act will reduce the ranks of the uninsured by roughly how many persons:
   • 8 Million
   • 17 Million
   • 32 Million

     The Congressional Budget Office estimates that by 2019, the Affordable Care Act will reduce the number of uninsured individuals by about 32 million.

     Congressional Budget Office, “Health Care: Estimates for March 2010 Health Care Legislation” (2010). https://www.cbo.gov/publications/collections/health.cfm

   • 42 Million
4. • True or False: The Affordable Care Act will impose “death panels” that decide on the end-of-life care provided to elders.
   • True
   • False

     In 2009 a proposal that would allow Medicare to pay for patients to have optional discussions with their doctors about living wills and other end-of-life issues was blatantly mischaracterized as “death panels” set up to determine if seniors and the disabled should receive medical care. Though the provision is no longer included in the law, PolitiFact identified the “death panel” myth as the 2009 Lie of the Year.

     Anqie Holan, “PolitiFact’s Lie of the Year: ‘Death panels,’ ” Tampa Bay Times, December 18, 2009. https://www.politifact.com/truth-o-meter/article/2009/dec/18/politifact-lie-year-death-panels/

5. • True or False: The Affordable Care Act will ultimately fill the “donut hole” through which seniors pay a higher share of their prescription drug bills the more drugs they use.
   • True

     Under the Affordable Care Act, seniors receive a 50 percent discount on covered prescription drugs in the Medicare Part D coverage gap in 2012, also known as the “donut hole.” Coverage for prescription drugs will increase each year until the coverage gap closes in 2020. More than 2 million seniors saved more than $1.2 billion on prescription drugs—an average of $550 per person—in 2011 alone.

     Centers for Medicare & Medicaid Services, “Seniors save more than $1.2 billion on prescriptions thanks to the Affordable Care Act,” Press release, November 4, 2011. https://www.cms.gov/apps/media/press/release.asp?Counter=4158&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

   • False
6. • According to current projections, if we do not address rising health care costs in the United States, health care spending by 2019 will equal what percent of gross domestic product:
   • 10 percent
   • 15 percent
   • 19 percent

     Health care costs continue to rise in the United States. In fact, according to the Centers for Medicare & Medicaid Services, average annual health spending growth is projected to outpace annual growth in the overall economy from 2009 to 2019.

     Centers for Medicare & Medicaid Services, “NHE Fact Sheet” (2012). https://www.cms.gov/NationalHealthExpendData/25_NHE_Fact_Sheet.asp

   • 25 percent
7. • True or False: The individual mandate under the Affordable Care Act will force Americans to buy insurance that they can’t afford.
   • True
   • False

     The Affordable Care Act provides a “hardship” exemption for people who cannot afford insurance so they do not have to pay any penalty for not purchasing an insurance plan if the cheapest plan available exceeds 8 percent of their income. And it provides options outside of the private insurance market that will help lower costs and give more affordable choices to those purchasing insurance.

     The White House, “Policies to Improve Affordability and Accountability,” https://www.whitehouse.gov/health-care-meeting/proposal/whatsnew/affordability

     U.S. Department of Health and Human Services, “Choices” (2012). https://www.healthcare.gov/law/features/choices/index.html

8. • True or False: If you are insured today, the Affordable Care Act does nothing for you.
   • True
   • False

     The Affordable Care Act protects you if you lose your insurance and lowers the costs you pay for your insurance by holding insurance companies accountable. For instance, insurance companies will now be required to justify any rate increase of more than 10 percent and will no longer be allowed to impose lifetime limits on most benefits. The act also provides free preventive care services as a part of an increased focus on prevention.

     U.S. Department of Health and Human Services, “Costs,” https://www.healthcare.gov/law/features/costs/index.html

     U.S. Department of Health and Human Services, “Preventive Care,” available at https://www.healthcare.gov/law/features/rights/preventive-care/index.html

9. • The Affordable Care Act:
   • Reduces the deficit

     According to the nonpartisan Congressional Budget Office, the Affordable Care Act will reduce the deficit by more than $100 billion over the next 10 years and by more than $1 trillion in the 10 years after that. The plan includes many deficit-reducing reforms including a tax on insurance companies offering high-priced plans and a pilot program to bundle payments to hospitals and other providers so Medicare patients will receive more efficient quality care.

     Peter Orszag, “The Affordable Care Act and the Deficit,” The White House Blog, June 2, 2010. https://www.whitehouse.gov/blog/2010/06/02/affordable-care-act-and-deficit

     Peter Orszag, “Following Doctor’s Orders,” Office of Management and Budget Blog, April 1, 2010. https://www.whitehouse.gov/omb/blog/10/04/01/Following-DoctorOrders/

   • Increases the deficit
   • Has no effect on the deficit
   • Has a minimal effect on the deficit
10. • True or False: The Affordable Care Act is based on the successful health reforms in 2006 in Massachusetts.
    • True

      The health reform in Massachusetts was the basis for the Affordable Care Act, and the core structure of the plans is the same. This means that the enormous success in covering the uninsured and fixing broken nongroup markets that has been seen in Massachusetts will play out at the national level as well. But the Affordable Care Act is much more ambitious than the Massachusetts reform in trying to control health care costs.

    • False