A mandate requiring all persons over the age of 18 to acquire health insurance is a key component of both House- and Senate-passed health reform proposals. The concept of requiring people to acquire health insurance has drawn criticism from some on the right—who see it as a coercive intrusion by the federal government—and some on the left—who view it as a giveaway to insurance companies. Proponents of current legislation, however, view the individual mandate as both a necessary cost-control provision and a key step towards universal coverage.

While it is highly probable that an individual mandate will be part of the final health reform legislation, the exact nature of the individual mandate is still being debated. In this policy brief, the past, present and future of the individual mandate are scrutinized, as is the role that an individual mandate would play in implementing the largely interdependent pieces of reform.

The policy brief also looks at how individual mandate might practically function, including:

• How the government would help people satisfy the mandate;
• How the mandate would be enforced;
• What its basic requirement would be and what the definition of acceptable coverage is;
• Who would be exempted.