CASE STUDY - THE AFFORDABLE CARE ACT MARKET PLACES

QUESTIONS AND INSTRUCTIONS FOR CASE STUDY 2: THE AFFORDABLE CARE ACT MARKET PLACES

DUE DATE – 11:59 PM, SATURDAY, APRIL 24, 2021.

PURPOSE OF THE WRITING ASSIGNMENT: To make sure you understand why State Marketplaces/Exchanges are a key part of the Affordable Care Act of 2010, and what problems they are supposed to solve in terms of large group health insurance availability, comprehensiveness of coverage, and affordability.

1. USE THE RESOURCES INDICATED BELOW TO CREATE YOUR ANSWERS:

· OVERVIEW 7.A REVISED.: ACA MARKETPLACES/EXCHANGES AND MANAGED COMPETITION.

· READING 1: MARKET FAILURES IN HEALTH INSURANCE AND THE ORIGINS OF THE AFFORDABLE CARE ACT.

· READING 1.A.: AFFORDABLE CARE ACT OF 2010/ SLIDES 5, 7-8.

· VIDEO 1.B.: BEGINNING TO MINUTE 9:35.

· READING 1.B.: THE THREE-LEGGED STOOL

· READING 3.A.: THE ACA MARKETPLACES

2. PROVIDE WRITTEN RESPONSES TO THE QUESTIONS POSED BELOW.

Your response via BlackBoard Assignments should have the following format and follow the rules indicated below:

· Single spaced.

· In Arial 11 font.

· No more than 1 ½ - 2 pages long.

· Your response should be in a separate Microsoft Document attached to and submitted through Blackboard Assignments: CASE STUDY 2.

· Each SHORT paragraph of the response should correspond to one of the Questions.

· If you have made more than one response on Blackboard, I will read, grade, and respond to your most recent response by day and date.

QUESTIONS – PROVIDE A WRITTEN RESPONSE TO EACH QUESTION. WRITE A SHORT PARAGRAPH TO RESPOND TO EACH QUESTION.

MARKET FAILURE AND INDIVIDUAL HEALTH INSURANCE IN THE 2000’s. READING 1.

QUESTION 1.A. How did the private (non-governmental) health insurance market fail to meet the needs of individuals and very small businesses (under 100 employees) from 2000 through 2010? Briefly discuss no more than 2 examples.

QUESTION 1.B.: Why did private health insurance plans avoid issuing health insurance to individuals, especially from 2000 through 2010?? Why were they afraid that they could not make money if they provided affordable health insurance plans to individuals, especially those with Preexisting Conditions?

MANAGED COMPETITION – CREATING A REGULATED HEALTH INSURANCE MARKET WITH AFFORDABLE INSURANCE OPTIONS FOR INDIVIDUALS AND VERY SMALL BUSINESSES.

READING 7.A .; VIDEO 1.B.; READING 1.B.

QUESTION 2.A.: In the theory of Managed Competition , as it is applied to State health insurance marketplaces under the ACA, which governments act as Sponsors in creating and managing the Market Places?

QUESTION 2.B.: In the theory of Managed Competition , as it is applied to State health insurance marketplaces under the ACA, briefly describe TWO (2) of the key goals of a Sponsor in setting up and managing a Market Place.

THE THREE-LEGGED STOOL – LEG NUMBER 1: RULES OF THE REGULATED MARKET.

USE THESE RESOURCES: OVERVIEW 7.A.; VIDEO 1.B.; READING 1.B.; READING 3.A.

QUESTION 3.A.: In the ACA State Market Places – Do the 4 “Metal” health insurance plans offered by private insurers in each State differ in terms of the medical services covered, in terms of premiums, and/or in terms of requirements for out-of-pocket expenditures?

QUESTION 3.B.: With respect to health insurance eligibility, and the amount of premium to be paid for health insurance: What are the Market Place rules and regulations concerning people with Preexisting conditions?

THE THREE-LEGGED STOOL – LEG 2: THE INDIVIDUAL MANDATE. OVERVIEW 7.A.; VIDEO 1.B.; READING 1.B.

Question 4: Briefly describe the key reason for the Individual Insurance Mandate in the original Affordable Care Act.

THE THREE-LEGGED STOOL – LEG 2: FINANCIAL SUBSIDIES FOR HEALTH PLAN MEMBERS.

OVERVIEW 7.A.; VIDEO 1.B.; READING 1.B.; READING 3.A.

Question 5.A: Briefly describe the TWO (2) types of financial subsidies provided to health insurance plan members in the ACA Market Places.

Question 5.B: Which type of subsidy is limited to Silver Plan members within a narrow income range?