Federal Healthcare Policy Howlett (2009) states that policy goals and means "exist at different levels of abstraction and application and policies can be seen to be comprised of a number of components or elements, not all of which are as amenable to (re)design as others." Successful policy design is reported in the work of Howlett to require the following:

(1) that policy aims, objectives and targets be coherent;

(2) that that implementation preferences, policy tools and tool calibrations should also be consistent; and (3) that policy aims and implementation preferences; policy objectives, and policy tools; and policy targets and tool calibrations, should also be congruent and convergent. (Howlett, 2009)

Policy instrument choices are reported to be such that are "nested or embedded" in the relationship that exists within "a larger framework of established governance modes and policy regime logics." (Howlett, 2009)

Required Health Care Coverage

This study intends to examine the subject of required health care coverage. According to Howlett, requiring health care coverage in the U.S. is "…a far-reaching requirement that spans the local, national, and federal laws and court systems and ultimately brings to issue the policy in terms of its consistency with the constitutional framework of federalism." (Harkness, 2005)

The affordable health care act was passed just recently and sets out a requirement that every individual obtain health care coverage or alternatively that they...

Peter Harkness states that it is expected that the decision "…will have significant repercussions in the states. Under the law, states and insurers have to be ready to sign up 32 million new enrollees either for Medicaid or private insurance plans by 2014 using online insurance marketplaces known as exchanges, designed to help individuals and small businesses shop around for acceptable policies. All states are supposed to provide standardized, customer-friendly application processes to help consumers, including low-income individuals applying for the expanded Medicaid program." (Harkness, 2005)
II. Support for the ACA

In regards to federalism, Harkness states that this ACA could potentially become a case study in healthy federal-state relations." (2005) The cooperative federalist program is such characterized by government establishment of program core requirements allowing the states the necessary freedom to implement their own programs. In addition, 11 states including Oregon filed an amicus brief arguing that the reform act provides states with even more freedom. Specifically…