Examining the Individual Mandate

Supporting Lectures:

Review the following lecture:

  • Policy Formulation: Agenda Setting (see below)

Examining the Individual Mandate

The Affordable Care Act (ACA) requires all US citizens and legal residents to obtain qualifying health coverage. In this week, you will explore the Individual Mandate section of the new health reform law.

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  • **Explain the Individual Mandate included in the Patient Protection and ACA including the tax penalties that will be imposed if a person or a family does not obtain qualifying health coverage.
  • **Analyze the eligibility criteria for exemptions and subsidies to obtain coverage.
  • **Explain one policy change or enhancement you would recommend if you were required to ensure the success of the Individual Mandate included in the Patient Protection and ACA and justify the intended outcome.

From the Internet, review the following:

  • HealthCare.gov. (n.d.). The fee for not having health insurance. Retrieved from https://www.healthcare.gov/fees/fee-for-not-being-covered/
  • Jost, T. (2017, August 21). The IRS Is Still Enforcing The Individual Mandate, Despite What Many Taxpayers Believe. Retrieved from https://www.healthaffairs.org/do/10.1377/hblog20170821.061615/full/

Submission Details:

  • Submit your response in a 4- to 6-page Microsoft Word document formatted in APA style.
  • On a separate page, cite all sources using APA format.


Policy Formulation: Agenda Setting

The existence of health related societal problems does not automatically trigger policy changes that solve such problems. Each problem needs to be understood including all its complexity, solutions and potential solutions need to be identified, and the current political circumstances need to be understood in order to assess the will of the pubic as well as law makers. As it happens, the problems that are identified as important or urgent get immediate attention from policymakers. Aggressive congressional intervention usually depends on its public salience and the degree of group conflict surrounding it. Some problems gain traction simply due to a confluence of events and political ripeness. Potential solutions to problems may not be readily present and will need formulation.

Alternatively, policy making can be slowed if there are several potential solutions, each favored by a different interest group. Analysis plays a key role in identifying optimal solutions for inclusion in a policy. Apart from an analysis of advantage-to-disadvantage of alternative solutions, there should always be an awareness of unintended consequences and room for evolution. In this regard, data driven analysis with quantifiable results always has a better chance of finding a place on the policy agenda. All other things being equal, the existence or lack of political will may render an agenda stagnant. The political circumstance surrounding each problem-potential solution is a crucial third variable in creating a window of opportunity.

Additionally, the influence and tenor of interest groups play a pivotal role in moving agendas forward. Sometimes, individual policymakers seem to make frustratingly counterintuitive decisions, and it may be because of how much power a certain interest group may wield over them. Interest groups may use strategies such as lobbying, campaigning through advertisements, organized protests, electioneering, litigation, as well as monetary “carrot and stick” tactics. Lastly, chief executives such as presidents, governors, mayors, etc. also influence policy agenda.

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