The Challenges and Political Influence on Healthcare Reform: An Analysis of the Affordable Care Act


There have always been numerous calls to reform the American healthcare system. Despite these efforts, many of the choices made by policymakers tend to align more with the interests of their political parties.

Opposition to the Affordable Care Act

The majority of the issue found with the Affordable Care Act was the person and party from which these ideas came. Many members of the Republican Party sought to oppose the policies and practices of the Obama Administration (Skocpol & Jacobs, 2018). Due to pressure from constituents, many legislators continued to vote against the efforts of ObamaCare.

Attempts to Undermine the Affordable Care Act

During the Obama administration, many attempts were made to sabotage the Affordable Care Act, and one of these attempts came from Marco Rubio after attacking a provision in the law that he began to call insurance bailouts (Long & Masi, 2018). The use of this language reflects a refusal of many conservatives to support seemingly bailing out large companies in financial crisis. However, continued efforts were made to undermine the Affordable Care Act during the Trump Administration (Keith & Moniz, 2019). One of these numerous attempts came from cutting ACA subsidies that reduced the risk of insurance companies losing money by participating on the exchanges.

Current Status of the Affordable Care Act

The ACA is still in place as no law has been passed to replace this policy. Despite numerous votes, the ACA is still in place, but during the Trump Administration, the individual mandate portion of the ACA was removed (Blumberg et al., 2019).


In conclusion, the American healthcare system has witnessed ongoing debates and challenges in the reform process, with political interests often shaping policy decisions. The Affordable Care Act has faced opposition from Republicans, attempts at sabotage, and modifications during the Trump Administration, yet it remains in place, albeit with certain changes. These complexities highlight the intricate nature of healthcare reform and the influence of political dynamics on policymaking in the United States.


Long, S. K., & Masi, M. V. (2018). Access and affordability: An update on health reform in the United States. Annual Review of Public Health, 39, 113-133.

Oberlander, J. (2018). The troubled politics of the Affordable Care Act. Journal of Health Politics, Policy and Law, 43(2), 221-241.

Skocpol, T., & Jacobs, L. R. (2018). The Republican War on Obamacare: Explaining conservative opposition to the Affordable Care Act in Congress. Journal of Health Politics, Policy and Law, 43(4), 511-538.

Keith, K., & Moniz, S. (2019). Effects of Trump Administration actions on insurance coverage and premiums in the individual marketplaces. JAMA, 321(8), 742-743.

Blumberg, L. J., Buettgens, M., Feder, J., & Holahan, J. (2019). The Affordable Care Act’s individual mandate penalty was reduced to zero: An exploration of the market and coverage implications. Urban Institute, Health Policy Center, Research Report.