1. The ACA re-organized the non-group market (into so-called Marketplaces in each state) with new rules requiring insurers to sell specific comprehensive benefit packages to all persons not eligible for public or affordable employer-based insurance, regardless of health status, at a common community rated price, AND requiring all to purchase while providing income-related premium and cost-sharing subsidies.These reforms all work as a package, which is why regulations which allow "escape" from the ACA Marketplaces are so dangerous to the stability of equilibrium.Which of the following rules proposed or enacted by the Trump Administration would NOT raise premiums in the Marketplace?

a. Ending the individual mandate to purchase

b. Ending the cost sharing subsidies

c. Allowing limited-benefit and limited-duration plans to be sold outside the Marketplaces to the healthy only

d. Allowing limited benefit plans to be sold inside the Marketplaces

e. All of the above

f. None of the above (they all would raise premiums inside the Marketplaces)

2 . The ACA paid for its coverage expansion with Medicare savings (payment cuts and reforms) and taxes on higher income people.In the long run, the hope is that Medicare savings from payment reforms will increase their share of the financing burden.This will serve to keep all taxes - income and Medicare-specific taxes -- lower than they would otherwise be.Unfortunately, one of the most prominent payment reforms, the shared savings version of accountable care organizations, has been shown to cost Medicare more than it saved, at least through 2016.This was primarily because:

a. Less than 1/3 of Medicare beneficiaries chose to be in an ACO

b. It takes at least 7 years to save money with payment reforms in health care

c. Shared savings with no downside risk impart weak incentives to control total cost of care

d. Primary care is the key to saving health care spending and ACOs mostly ignored primary care