At the start of their term, the Obama administration pledged to reform two failing policy systems in the United States: immigration and health care. The Latino populations' attitudes toward these two critical policy areas are particularly relevant due to the large foreign born population in the Latino community and the large number of Latinos who lack health insurance. Yet studies have not examined what factors shape Latino approval ratings and whether support for health and immigration reform affect Latino approval ratings of the current administration. We use the 2009 Latino Decisions survey and find that the foundations of Latino approval ratings are political in nature, with support for health and immigration policy reform driving support of the current administration. Given the vital role the Latino electorate played during the 2008 election, the success of these two policy reform efforts may have major implications for the 2012 elections. (Contains 3 figures and 1 table.)