Health Policy Proposal Analysis (Policy Brief)

Unintended Consequences of the Individual Mandate

I chose the individual mandate which is a requirement of all Americans, unless exempted, to have basic coverage of health insurance. It is a healthcare reform that came into law in 2010 and was known as Obamacare or the Affordable Care Act. The legislation calls for a tax penalty for those who fail to have the insurance coverage (Laureate Education, 2011).

Positive Results of the Individual Mandate

Just like any other insurance policy, health insurance creates risk pools among policyholders. The individual mandate resulted in having many healthy people paying premiums which helped pay for health costs for those who got sick and could not afford the medical costs on their own. The risk pool becomes wide enough when more people, especially the healthy, and this lowers the premiums for everybody including those with expensive medical requirements. Thus, healthcare is more affordable and accessible to more Americans. Therefore, the individual mandate reduced the number of Americans who did not health insurance and lowered the insurance premiums. It also reduced the government’s cost of subsidizing the insurance coverage for those who are newly insured (Blumental, Abrams & Nuzum, 2015).

Unintended Consequences of the Individual Mandate

However, there were negative consequences that came with the individual mandate. Critics saw it as a financial burden and an unconstitutional violation against personal liberty. Opponents argued that citizens have the right to make their own health decisions and live without the government interfering with their social matters. Further, the individual mandate became less popular as people opposed the penalties imposed on them if they failed to pay for their health insurance. The matter was actually taken to the Supreme Court to determine whether the mandate was a constitutional exercise of the government to exercise its taxing power (Blumental et al., 2015). A significant number of Americans believe that the legislation has done more harm than good to state residents. Among these are those opposing government meddling in their personal health matters and forcing them to have insurance. Others are those opposing the tax penalties imposed for failure to pay for the health insurance.

Issues to be considered by Organizations and Nursing Profession

There are a number of factors that my organization have to consider with the individual mandate. To begin with, the nursing profession need to keep up with the Affordable Care Act changes and fully comprehend the nature and complexity of health insurance. This way, they can educate and inform health consumers who come to the hospital about their health insurance requirements and coverage (Bodenheimer & Grumbach, 2016). Further, even with the increased health coverage enabled by the individual mandate, organizations are still facing some challenges that they need to handle. For instance, there are gaps found in health access that need to be addressed and filled. There has also been an increased dependency on emergency care as compared to preventive care, particularly among the poor population. To this end, hospitals need to come up with more innovative public health intervention strategies so as to ensure there are healthy individuals across all socio-economic classes (Bodenheimer & Grumbach, 2016).

Health organizations are also being faced by extra costs as more Americans are gaining access to their health services. Therefore, a hospital like the one I work in needs to get a better understanding of the ACA plans and learn how to effectively budget for the additional costs. Health professionals need to come in handy in advising and guiding the hospital administration and staff in navigating the various options as well as the respective costs. 

References

Blumental, D., Abrams, M., & Nuzum, R. (2015). The affordable care act at 5years. 2451-2458.

Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th Ed.). New York, NY: McGraw-Hill Medical.

Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy: Reforming health care delivery: Accountable care organizations.