Deck 4: Medicaid and Chip

Question 1

What was one of the key components of the Kerr-Mills Act?

A) Placed limits on the authority of insurance companies to impose pre-existing condition exclusions
B) Allowed states to include the "medically needy"
C) Provided subsidies for workers without insurance
D) Provided federal funds to subsidize construction of hospitals in areas of bed shortages

Answer 1

B

Question 2

The generally accepted political explanation for the creation of Medicaid is

A) that the program was created almost as an afterthought to Medicare
B) It was intended to "pick up the pieces" left over by Medicare
C) It was designed to cover deductibles and coinsurance for indigent Medicare patients
D) All of the above

Answer 2

D

Question 3

Which of the following is an example of the differences between Medicare and Medicaid?

A) Medicare is tied in to Social Security
B) Medicaid is stigmatized as being a public assistance program
C) Medicaid is financed by the federal as well as the state governments
D) All of the above

Answer 3

D

Question 4

Which of the following is not true about the Medicaid program as it exists today?

A) It is administered and financed totally by the federal government
B) About 60 percent of non-disabled program enrollees have a job
C) A large majority of the program enrollees receive their health care services through private managed care plans
D) On a per-enrollee basis, Medicaid is a low-cost program compared to private insurance.

Question 5

Which of the following was not the primary objective of the Medicaid program when it was created in 1965?

A) To provide a limited number of poor individuals with financial assistance to meet their medical needs
B) To provide financial assistance to meet the healthcare needs of everyone who fell below the federal poverty guidelines
C) Limit the program eligibility to "deserving" or "worthy" poor
D) To serve as a "medical welfare" since it was also closely tied to some of the welfare programs

Question 6

Medicaid program is not an excellent example of how the federal structure of government

A) Allows states to act as laboratories for innovation and experimentation with the program
B) Creates duplications and overlapping jurisdictions between different levels of governments
C) Helps create a unified system of healthcare throughout the country
D) Creates problems of inefficiencies and inequities since the program eligibility ands services vary considerably across states

Question 7

The Affordable Care Act of 2010 provided states with financial incentives to

A) Dramatically reduce their spending on the Medicaid program
B) Expand their Medicaid programs to cover more individuals
C) Eliminate Children's Health Insurance Programs (CHIP)
D) Significantly tighten their eligibility requirements to reduce the number of people eligible for the program

Question 8

In order to participate in Medicaid, the federal government requires states to cover certain population groups called "mandatory eligibility groups." The "mandatory eligibility groups" include all of the following groups except one. Which is the exception?

A) Pregnant women with income below 138 percent of the Federal Poverty Level
B) Children through age 18 in families with income below 138 percent of FPL
C) All single parents with children
D) Most elderly and persons with disabilities who receive cash assistance through the Supplemental Security Income (SSI) program

Question 9

The Affordable Care Act of 2010 established a new methodology to determine income eligibility for the Medicaid and CHIP programs. It is called

A) Modified Adjusted Gross Income
B) Modified Adjusted Net Income
C) Total Gross Family Income
D) All of the above

Question 10

Those individuals who are qualify for both Medicare and Medicaid programs because of their age and income are referred to as

A) Double dippers
B) Duplicates
C) Over lappers
D) Dual eligible

Question 11

States' share of Medicaid expenditures (state financing) comes from all of the following sources except one. Which is the exception?

A) Appropriates from state legislatures
B) Local property tax
C) Provider taxes
D) Cost sharing imposed by state government

Question 12

Under the CHIP program, states were given the option to expand health insurance coverage to children by

A) Build on existing Medicaid program institutional structures
B) Create a new program, separate from Medicaid
C) Utilize a combination of both - expand existing Medicaid program as well as establish a separate program
D) All of the above

Question 13

In NFIB v. Sebelius (2012) the United States Supreme court ruled that

A) The federal government had the authority to withdraw federal funds from the original Medicaid program if states refused to expand their Medicaid program
B) Requiring states to expand their Medicaid program was unconstitutional and states could voluntarily join or to opt out of the expansion without fear of losing federal matching funds for the original Medicaid program
C) The Affordable Care Act was unconstitutional
D) The federal government must provide states with additional funds to expand their Medicaid program

Question 14

When it came to Medicaid expansion and implementation, the reactions of state officials included

A) A group of largely Democratic officials who immediately committed to participate and expand
B) A group of largely Republican officials who immediately opposed expansion on the ground of added cost to the states
C) A group of largely Republican officials who were ambivalent and opposed to expansion in general but did not completely rule out expansion in the future
D) All of the above

Question 15

Factors that help explain states decision to expand their Medicaid program under the ACA included all of the following except one. Which is the exception?

A) A presence of Republican controlled state legislature had a positive impact on state's decision to expand
B) States with well-established and generous social programs for low-income individuals are more willing to expand their Medicaid program.
C) Partisanship and political ideology
D) Affluence/economic conditions of the state

Question 16

Reason cited by states for expanding their Medicaid programs include

A) Medicaid expansion is a good policy for both uninsured patients and healthcare providers
B) Extending health insurance coverage under Medicaid expansion is good for both physical and mental health of the uninsured
C) The federal financial incentive is too good to pass up
D) All of the above

Question 17

States that expanded their Medicaid program under the ACA have experienced all of the following except one. Which is the exception?

A) A significant gain in health insurance coverage
B) Increased access to healthcare and increased utilization of healthcare services
C) Increased in healthcare disparity between whites and blacks/Hispanics
D) A reduction in uninsured visits and uncompensated care costs for hospitals, clinics and other providers

Question 18

Argument against Medicaid expansion under the ACA by the opponents included

A) Medicaid is an inefficient program that is riddled with waste, fraud, and abuse
B) Medicaid expansion would lead to more federal control and authority over states
C) The federal government cannot be trusted to keep its promise of funding 90 percent of the cost of expansion in the future
D) All of the above

Question 19

Which of the following is false?

A) A higher proportion of low-income individuals in non-expanding states have a regular source of healthcare
B) A higher proportion of low-income individuals in non-expanding states have a lower rate of dental checkups, routine physical check, blood pressure check, and flu vaccinations
C) There have been no major differences in health insurance gains and coverage between the expansion and non-expansion states
D) Low-income individuals in non-expansion states are more likely to be black and reside in rural areas

Question 20

Medicaid enrollment and expenditures can fluctuate and is influenced by

A) Economy
B) Major policy changes in the program
C) Fluctuation in local property values
D) A and b only

Question 21

Under Medicaid managed care delivery system

A) Healthcare providers deliver health benefits and services to Medicaid enrollees through contracted arrangements between state Medicaid agencies and managed care organizations
B) state governments provide all Medicaid services through one state agency
C) Federal government determines the prices healthcare providers charge for their services
D) State governments place a maximum limit on spending for Medicaid spending and once the limit is reached services are cut off

Question 22

The underlying assumption of consumer-directed health care plans is that

A) Consumers would make more informed choices and forego unnecessary medical care if they had to use more of their own money to pay for it
B) It would exacerbate the problem of moral hazard in health insurance market
C) Consumers will engage in more risky and wasteful health behavior
D) All of the above

Question 23

The Centers for Medicare and Medicaid Services under the Trump administration issued new guidelines for states seeking Section 1115 demonstration project waivers seeking to impose a work requirement on "able-bodied" individuals. The exceptions to the "work requirements" include

A) Children
B) Individuals with disabilities
C) Pregnant women
D) All of the above

Question 24

Which Medicaid beneficiary group is the costliest?

A) Elderly
B) Children
C) AFDC recipients
D) Disabled

Question 25

According to the authors, why are states encouraging/requiring Medicaid beneficiaries to enroll in managed care?

A) The belief that it will significantly help reduce program costs
B) The belief that it will provide beneficiaries better access to high-quality care
C) It fits into the general trend toward privatization
D) All of the above

Question 26

During the seventeenth century, colonial statutes assigned the responsibility for taking care of the impoverished frail elderly and disabled to the

A) Local governments funded by the local poor tax
B) State governments funded by general revenue
C) Federal government funded by income tax
D) Private hospitals

Question 27

States have increased their reliance on home and community-based services (HCBS) and less reliance on nursing facilities for long-term care services in their Medicaid programs because

A) Many older persons prefer the HCBS alternative because it gives them more privacy and control over their own lives
B) HCBS alternatives are generally less expensive per resident in the long run
C) HCBS options have broad-based political/ideological appeal
D) All of the above

Question 28

A great deal of long-term care services is provided

A) by nursing homes
B) private hospitals
C) informally by family care givers
D) churches

Question 29

Challenges faced by long-term care in the United States include all of the following except one. Which is the exception?

A) Continuous decline in the elderly population
B) Recruitment and retention of a well-trained and stable workforce
C) Financing the cost of long-term care
D) insufficient quality of care

Question 30

Research on Medicaid Pay-For-Performance (P4P) suggests that

A) It has failed to improve quality
B) It has been successful in reducing costs
C) Doctors for caring for the poorest and sickest patients are rewarded under the P$P system
D) All of the above