Kick the can down the road ...
The great clusterf*ck that is US healthcare primarily depends on putting the problem on somebody else's back.
The new Affordable Care Act (affectionately known as 'Obamacare') hugely depends on federal subsidies for poor enrollees via Medicaid. States enrolled in the program currently see little increased burden as these subsidies cushion the impact on the state medicaid share. These subsidies will end, however, and the huge cost shift will impose a crushing burden on states already struggling with massive budget problems. At that point, the ACA system will implode.
Much sooner, however, is the anticipated attack by a newly empowered Republican majority in Congress (House and Senate) which carries a self-perceived mandate to eviscerate or repeal the ACA. Some pundits have bravely suggested that the Republicans dare not attack a program that for the first time ever hints at equitable health care for all Americans, but that remains to be seen. The Republicans are engaged in an internal power struggle reminiscent of the Night of the Long Knives. The ACA is a prime target.
Long term, the US voter refuses to accept any plan that smacks of Socialism, and Congress ensures that no plan will exclude the multitudinous private insurance industry or impose cost negotiations on pharmaceutical corporations.
In short, any plan to reform health care or curb steadily soaring costs in the US is stillborn upon delivery.