Introduction
The contemporary economy-driven political sphere is influenced by multiple factors that trigger policy-making related to essential domains of the population’s life, health care being one of the critical ones. Health care insurance has long been a debatable issue with views ranging from single-payer systems to governmental coverage to minimum coverage (Epstein, 2019). The latter has been promoted in the USA’s legislation for the past decade to reform health care in a way that would benefit the economy of the state (Fiedler, 2020).
The “Individual Mandate” provision of the 2010 Patient Protection and Affordable Care Act (PPACA) was both supported and objected to since its introduction, to be finally repealed in 2017 (Fiedler, 2020). Since this public policy cultivates the norms for mandatory health care coverage for all citizens and penalties for non-compliance, there are controversial attitudes towards such an approach that serves the economy more than the society. The present paper is designed to explore and analyze the worldviews behind the Individual Mandate policy, conflicting and supporting views concerning its effectiveness, and the governmental role in its provision.
The Individual Mandate Policy Overview
The policy enforced within the Individual Mandate has been long debated and ultimately repealed. However, the approaches’ benefits are sound from an economic perspective since the monetary assets obtained by the means outlined by the policy might bridge the gap in the American healthcare system’s insufficient funding. Starting in 2014, the Individual Mandate (IM) provision of PPACA necessitates all eligible American citizens to pay a mandatory minimal health care insurance coverage (Mach, 2015).
In case of non-compliance with the provision, uninsured individuals are to pay penalties promptly. Indeed, according to the Affordable Care Act (ACA), most individuals are “required to maintain minimum essential coverage for themselves and their dependents” (Mach, 2015, p. 2). The term minimum essential coverage is defined by the list of coverage options, either government-sponsored or private insurance, and the options that are not recognized by the document as minimum essential coverage.
The sum of penalties is calculated according to tax percentage and cannot exceed “the national average premium for bronze-level health plans offered through health insurance exchanges” (Mach, 2015, p. 5). However, there are exceptions for particular population groups that are not subject to penalties in case of non-compliance with the Individual Mandate policy. Therefore, the policy includes both characteristic social inclusion when requiring mandatory insurance by recognizing vulnerable populations and economic benefits that coverage and penalties are expected to contribute to the budget.
The core of the debate is related to the disparities in health care access and affordability this document implies. Some researchers state that such an approach to minimum essential coverage will cause a surge in the uninsured population, increasing the gap in health inequality (Lanford & Quadagno, 2016). However, other scholars refute these statements by providing evidence regarding the positive impact of the Individual Mandate on racial minorities, stating that these populations largely benefited from the increased insurance coverage (Buchmueller et al., 2016). Altogether, no consensus on the effectiveness of the Individual Mandate of the ACA has yet been reached.
Supporting Views
The political viability of the provision is one of the most compelling arguments in favor of the Individual Mandate. Indeed, “Roughly half of Americans have a favorable opinion of the ACA, and a large majority support the law’s financial assistance provisions and consumer protections” (Karpman & Long, 2017). Health policy experts agree that the mandate is needed to reduce adverse selection in the nongroup market (Holahan et al., 2017, para. 2). Recent findings argue that implementing the Individual Mandate has significantly expanded the overall insurance coverage, accounting for approximately 70% of the general increase (Duggan et al., 2019).
Furthermore, the percentage of uninsured patients administered to hospitals has decreased by 2%, while the number of such in emergency care departments was lowered from 16% to 8% (Duggan et al., 2019). This data supports the argument that the application of the Individual Mandate considerably elevated the US population’s ability to gain health insurance.
Another promising change introduced by the provision discussed is the incredible decline in various social groups’ healthcare spending resources. Buchmueller et al. (2016) provide considerable evidence in favor of the Individual Mandate, arguing that the ACA has reduced the racial and ethnic disparities previously, decreasing the number of uninsured Hispanic population by 7.1%. In addition, Jung and Tran (2016) state that welfare gains for low-income individuals in poor health have increased tremendously, offering such people the possibility to obtain proper medical services. Overall, recent research supports the affluence of the Individual Mandate regarding the successful growth of insurance coverage rates and catering to disadvantaged families.
Opposing Views
Some aspects of the Individual Mandate have raised the concerns of various scholars. As explained by Rochefort (2018), the behavioral branch of healthcare has suffered significantly from the ACA applications, mainly due to workforce shortages and the uncertainties in behavioral problems coverage. Moreover, it is necessary to note that the political environment regarding new medical implementations was not considered ideal, which resulted in a considerable conflict between the Democrats and the Republicans (Rochefort, 2018). The debates between the political parties have greatly affected the population, mainly due to their political preferences and public values. Lanford and Quadagno (2016) explore this issue in detail, clarifying that various community members were negatively affected by the Individual Mandate, lowering their welfare opportunities. It seems that the IM’s application adversely impacted both the social and the political environment of the United States.
Analysis of Government’s Role
The government officials’ actions are essential parts of the current discussion, as their regulations regarding the mandate directly influence its success. The ACA expansion stated that the federal government would provide the state officials with tremendous financial incentives, covering nearly 100% of the implementation costs at the beginning of the campaign in 2014 (Lanford & Quadagno, 2016). Furthermore, additional resources will be granted to the officials willing to utilize this approach, such as uncompensated care coverage. All of the facts mentioned imply that the USA government had assumed a leading role in this process, willing to present the local authorities with multiple benefits regarding the Individual Mandate.
The strategy implemented was widely examined by the scientific community representatives, providing both positive and negative reviews of this approach. Some scholars debate that these incentives can negatively affect the local officials, forcing them to convert to Medicaid (Lanford & Quadagno, 2016). The authors argue that it is necessary to consider the social environment of every state before granting such opportunities.
This research’s conclusions declare that expansion practices are highly inefficient in states with high conservatism and racial issues (Lanford & Quadagno, 2016). However, other scholars debate these findings, promoting the Individual Mandate’s efficiency in connection to government activities. Duggan et al. (2019) offer a contrasting view on this subject, announcing that the mandate’s implementation yielded successful results in those fears of health insurance coverage and the labor market. Altogether, multiple scientists discuss the potential complications and advantages all the ACA Individual Mandate, and further research is required to gain a better insight.
The Origins of Conflicting Views
The conflicts discussed appear to be exceptionally strong, with different scholars presenting highly contradicting evidence and viewpoints. Even though it can be significantly challenging to establish the origins of such disparities, some researchers theorize that the primary cause might lie in the political debate between the Republican and Democratic parties (Fiscella, 2016). It has been stated that the advertisement campaigns from both parties have tremendously impacted the public views on the subject of the Individual Mandate, forcing multiple individuals to adopt an unenthusiastic approach. While the Republican representatives primarily advocate that the ACA act is remarkably non-beneficial, most the Democrats explain the advantages of the Individual Mandate provision (Fiscella, 2016). Conflicting attitudes from the governmental authorities further impact the USA population, undermining the existing disparities.
Conclusion
To conclude, the Individual Mandate of the 2010 Patient Protection and Affordable Care Act was examined in detail in this work. While this provision’s overall goal appears to unite the USA citizens under affordable health care, the real-life consequences are far more complicated. It has been shown that the supporters of this campaign outline the positive effects of the Individual Mandate, such as adhering to low-income individuals. However, the opposing views also highlight the negative sides of this subject, for example, decreased labor opportunities. The American government’s role was proven to be incremental in this discussion, as it actively endorsed the implementation of the mandate. These attempts were also both embraced and criticized, mainly due to the Republican’s and Democrats’ influence.
References
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