Answer to Question 1
On March 23, 2010, the Patient Protection and Affordable Care Act was signed into law by President Obama. Basically, the new law expands health insurance coverage to 32 million more people by requiring them to buy health insurance. It also expands Medicaid coverage and reforms current insurance practices. U.S. citizens and legal residents would be required to buy minimal essential coverage. If their employer does not offer insurance, the insurance would be bought through state health insurance exchanges, which would be established by 2014 . A health insurance exchange is a marketplace where you can buy insurance. The exchanges are supposed to lower the price of insurance by allowing people to band together to get lower prices than an individual would have to pay. The exchanges will be state-based but established with federal start-up funds. The exchanges will have the power to require that the plans sold are in the interest of purchasers. Although the exchange would not be able to set premiums, it can require insurers to justify rate hikes, and if the exchange is not satisfied with the reason, it can refuse to sell that plan. The exchanges would not open to all customers, however. You can buy from an exchange if you work for a company with fewer than 100 employees, are unemployed, or are retired and not eligible for Medicare. The exchanges are not monopolies. An individual can buy insurance on the open market, but the insurer would have to charge the same price both within and outside of the exchange. If a person failed to buy insurance, he or she would have to pay a tax penalty of 695 per uninsured person (maximum 2085) or 2.5 percent of the family's income. Certain categories of people would be exempt, including those with religious objections, Native Americans, illegal immigrants, and prisoners.
The Patient Protection and Affordable Care Act requires most people to buy insurance, but millions would qualify for subsidies. Out of the estimated 25 million people who would shop in the health exchanges, about 19 million could be eligible for subsidies. Anyone with an income below four times the federal poverty level (federal poverty level: 22,000 for a family of four, or 10,800 for an individual; four times the federal poverty level: 88,000 for a family of four, or 44,000 for an individual) would be eligible for some sort of subsidy. If you earn three to four times the poverty level, you would not have to pay more than 10 percent of your income for health insurance. People who earn less would be required to pay a smaller percentage of their income; for example, individuals who make 14,000 and four-person families who make 29,000 would pay no more than 3 to 4 percent of their incomes. The federal subsidies would be paid to the insurance companies. In addition, Medicaid will be extended to those who earn less than 133 percent of the poverty level.
If your employer offers insurance, the federal government would still offer a subsidy so that your insurance premiums are less than 9.8 percent of your income, and you would have to buy your insurance on an exchange.
For businesses that employ more than 50 people but do not offer health insurance as a benefit, if one employee buys insurance and qualifies for a subsidy, the business will be taxed 2,000 for each full-time employee (less the first 30 workers).
The bill closes the donut hole in drug coverage for those older than 65 years, with a 250 rebate in 2010 . In 2011, people in the hole can purchase brand name drugs at a 50 percent discount. By 2014, states must expand Medicaid to cover childless adults. Through 2016, the federal government will pay all costs for those newly eligible for Medicaid.
The bill also reforms some of the practices of private insurance. Children cannot be denied coverage because of preexisting conditions; this went into effect 6 months after the bill's signing. No one can be denied coverage for preexisting conditions starting in 2014, and children can stay on their parents' insurance plans until age 26 . With certain exceptions, there can be no annual or lifetime dollar limits on coverage.
Answer to Question 2
D
The medical assistant often has to reassure and comfort the patient before effective communication c
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