Question

1. To fund the expansion of health insurance coverage of children, Governor Kulongoski proposed an 84.5 cents per package increase in the state’s cigarette tax. What was the result?

   	a.	The measure was revised to be a 1% health insurance assessment on the state’s 26 largest hospitals and eight largest health insurance companies, which failed to pass because of the opposition of the hospitals and insurers.
   	b.	Democrats held a three-fifths supermajority in the legislature and enacted the tax increase.
   	c.	The measure was referred to the voters and passed with the support of nearly 90 health, business, union, education, and children’s advocacy groups.
   	d.	The tobacco industry spent $11.4 million to defeat the measure on the basis that it was unfair to smokers and poorer people and an attack on freedom of choice.

QUESTION 22

1. The Medicare Part D drug plan has ____.

   	a.	failed to induce better performance by insurance plans because very few seniors leave bad plans or use their market power
   	b.	protected seniors from marketing abuses and other manipulative practices
   	c.	failed to broaden access to drug coverage for seniors
   	d.	successfully introduced market competition through consumer choice

QUESTION 23

1. Which group was, for the first time, directly and actively involved in Massachusetts health care reform efforts, broadening the constituency for reform?

   	a.	Health Care for All
   	b.	ACT! (Affordable Health Care Today)
   	c.	labor unions
   	d.	the Greater Boston Interfaith Organization

QUESTION 24

1. In 2011, the legislature was committed to not raising taxes and also to preserving the roughly $8 billion Rainy Day Fund. How did they accomplish that?

   	a.	by slightly raising the oil and gas production tax
   	b.	by cutting school funding and estimated requirements for health and human services
   	c.	by freezing salaries of state employees and legislators
   	d.	by significantly raising the oil and gas production tax

QUESTION 25

1. In the early 1990s, Massachusetts created a demonstration program, the MassHealth Program, that included a number of coverage expansions under one umbrella program. This was done through ____.

   	a.	the Children's Medical Security Plan
   	b.	the Uncompensated Care Pool
   	c.	a comprehensive Medicaid waiver (a 1115 waiver)
   	d.	the State Children's Health Insurance Program

Answer 1

21. (d) The tobacco industry spent $11.4 million to defeat the measure on the basis that it was unfair to smokers and poorer people and an attack on freedom of choice.

22. (c) failed to broaden access to drug coverage for seniors

The result is excessive costs associated with the provision of pharmaceutical care and increasing limitations on access to the most appropriate prescription drug products under Part D.

23. (b) ACT! (Affordable Health Care Today)

The ACT (Affordable Care Today) Coalition introduced a bill that expanded MassHealth (Medicaid and SCHIP) coverage and increased health coverage subsidy programs and required employers to either provide coverage or pay an assessment to the state. The coalition began gathering signatures to place their proposal on the ballot in November 2006 if the legislature did not enact comprehensive health care reform, resulting in the collection of over 75,000 signatures on the MassACT ballot proposal.

24. (b) by cutting school funding and estimated requirements for health and human services

25. (c) a comprehensive Medicaid waiver (a 1115 waiver)

Massachusetts submitted a request for federal approval of a Section 1115 Research and Demonstration Waiver to expand coverage and create cost efficiencies in the state’s Medicaid program. This is granted federal approval in 1995 and implemented in 1997.