Affordable healthcare is a necessity in every country. It helps the citizens of the country have access to quality healthcare services at an affordable cost, thereby improving a nation's health. The US is among the most developed countries globally and struggles to provide its population with affordable healthcare. In the quest to provide affordable care to Americans, numerous health reforms have been attempted, but most failed due to a lack of support. The last successful health reform was enacted in 1965 and regarded Medicare and Medicaid. Despite a series of health reform failures, the Affordable Care Act was successful in 2009-2010 and has proven instrumental in improving healthcare delivery and care affordability in the US. The ACA encountered numerous challenges before being enacted. This paper explores the approach used to ensure ACA’s success, lessons learned from past health reform failures, and compromises made when enacting the ACA.
President Obama's administration is credited with the successful implementation of the ACA. Obama used different strategies that ensured that his health reforms did not fail like those of his predecessors. The first strategy was commitment. The ACA would have failed in both houses if Obama never pursued comprehensive actions and need for reforms in and keep the pressure on in 2010 when the bill almost collapsed. Nancy Pelosi had an unwavering determination and commitment to complete the legislation even when many democrats lost their cool following the Massachusetts special senate election (Jacobs & Skocpol, 2011) . Also, the ACA would have failed if Harry Reid failed to mobilize the sixty democrats in 2009 to pass the bill.
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Additionally, Obama's administration held democrats together. Obama applied a strategy opposite of what Bill Clinton administration did. In 2009, the Tri-Committee bill was established, which helped coordinate the democrats, thereby avoiding divisions that resulted in the failure of 1993-94 health reforms (Oberlander, 2010) . Additionally, the bill reflected agreement and unity among the democrats regarding the structure and shape of the 2009-10 health reform. This agreement helped the democrats push for comprehensive health reforms without fearing political risks.
Moreover, Obama's administrations included major stakeholders in the healthcare industry when enacting the reform. The administration made deals with health stakeholders to brace the bill with an agreement to have millions of customers who would get insured (Oberlander, 2010) . The deals involved organizations like the American Hospital Association, which sup ported and contributed to the reform by reducing Medicare and Medicaid payments. Additionally, insurance companies had a financial motive. They targeted the larger market and were fearful that tougher reforms and regulations would be introduced to reform the healthcare sector if the bill failed.
After the success of the ACA in 2010, various lessons, such as social support and unity in the party, were learned from previous administrations. Social support involves including other stakeholders in the industry to make health reforms. Previous administrations had failed to include stakeholders, such as insurance companies and healthcare providers, when enacting reforms, which resulted in scrutiny of the reforms and eventually failure. In contrast, Obama's administration involved all healthcare sector stakeholders when making health reforms, whereby his administration promised a wider market for the insurance companies (Oberlander, 2010) . Also, party unity is essential during the passage of bills. Previous administrations had divisio ns within the parties, which reduced the vote, resulting in the reforms' failure. In contrast, the Tri-Committee bill was established by Democrats and improved cohesion and unity in the party, resulting in the success of the ACA passage.
In the passage of ACA, some compromises were made by Obama's administration. First, the administration negotiated and made deals with healthcare stakeholders, such as insurance companies. The insurance companies were promised a larger market, which was enough for them to support the bill. Other administrations ignored these stakeholders, resulting in the failure of their proposed health reforms. Additionally, Obama's administration avoided budgeting and tax proposals that would upset major players in the health sector and citizens. Instead, the administration embraced redistributive financing, whereby tax was increased on the wealthier Americans who wanted to expand their health insurance coverage. These compromises proved vital and helped in the ACA passage.
The ACA has been vital and among the best health reforms in American history. It has helped many Americans afford care; hence, they have money to spend on other basic necessities (Obama, 2016) . This view has helped me understand the importance and the role played by the ACA in improvin g healthcare affordability to all Americans. Additionally, it helps me understand how instrumental Obama's administration was in enacting the ACA, meaning that I have high regard for him as a health reformist and a US citizen with goodwill. I feel that repealing the ACA will negatively affect many Americans who can now afford healthcare because of the ACA. If the APA is repealed, most Americans will be unable to access affordable care, which will reduce the money they spend on other necessities.
References
Jacobs, L. R., & Skocpol, T. (2011). Hard-Fought Legacy: Obama, Congressional Democrats, and the Struggle for Comprehensive Health Care Reform. In L. R. Jacobs, & T. Skocpol, Reaching for a New Deal (pp. 53-104). Russell Sage Foundation.
Obama, B. (2016). United States Health Care Reform Progress to Date and Next Steps. JAMA, 316 (5), 525-532. https://dx.doi.org/10.1001%2Fjama.2016.9797
Oberlander, J. (2010). Long Time Coming: Why Health Reform Finally Passed. Health Affairs, 29 (6). https://doi.org/10.1377/hlthaff.2010.0447
