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ACA and the Incremental Nature of Policy Change Your comments will be graded on how well they meet the Discussion Requirements posted under Before You Begin. Democracies change their policies almost entirely through incremental adjustment. Policy does not move in leaps and bounds, thereby ensuring the stability of government (Miyakawa, 1999, p. 298). In light of this classic quote, what incremental gains have been made by passage and implementation of the ACA? What additional reforms will be necessary to move further toward health care access for all? Should a single-payer system be the ultimate goal for health care in the United States? Be sure to explain your answers and cite reliable sources to support them. Reference: Miyakawa, T. (1999). The science of public policy: Essential readings in policy sciences I. New York: Taylor & Francis.