What principal features of the U.S. health care system helped or hindered the enactment of federal health reform in March 2010?

Review this week’s Learning Resources and media presentation, reflecting on the evolution of health care in the United States and the public’s response to health care reform efforts historically and currently.
Consider: What principal features of the U.S. health care system helped or hindered the enactment of federal health reform in March 2010? What challenges were encountered?
How do these conditions and/or challenges reflect characteristics of the policy process and the political environment?