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Keywords:

  • Affordable Care Act;
  • health reform;
  • health politics;
  • policy implementation;
  • Medicaid;
  • insurance exchange

This essay reviews recent developments in the field of health policy. It identifies a variety of frameworks brought forward to explain the enactment of health reform, including pivotal politics, path dependence, and multiple streams. It further identifies various challenges for the implementation of reform with a particular focus on state–federal relations and cost containment.