Abstract. The article focuses on a healthcare reform, one of the pillars of Barack Obama’s presidency. The author argues that the reform was driven by social considerations, and the goal was to make the American healthcare system more just by implementing universal mandatory health insurance. The author analyses how implementation of Obama’s reform has turned into an arduous process, and why the enactment of some of its regulations were postponed. The article examines why some of the new regulations have already begun to function, while others are due to begin in 2018 and 2020. In 2014 the reform entered its critical phase, as its most controversial element on mandatory health insurance for all Americans came into effect. Failure to comply is met with the fine, while citizens with low incomes can rely on state support. Opponents of the reform are still undertaking efforts to eliminate the universal health insurance requirement. The author comes to the conclusion that despite the challenges Obama has already made the pages of history as the president who succeeded in implementing universal health insurance. One of his greatest achievements has been the triumph over many of the healthcare reform’s opponents as he wrote the reform into law in the spring of 2010. All previous attempts to reform the national system had been met with failure due to conservative resistance. The controversy around this topic stems from many Americans’ understanding of fundamental values. The central point of debate is not about the American healthcare system, but rather about what kind of country the United States of America will be in the 21st Century. Democrats believe that the reform will make the country more just, while their opponents fear that the USA will turn into a welfare state with less freedom and more control of federal authority.