1. A still-struggling economy
Unemployment remains at 7.9%, and hiring is too slow to adsorb the millions on unemployed Americans. Economic growth is down to only 2%, and the US is slowly crawling out of the worst economic downturn since the Great Depression.
2. The fiscal cliff and budget deficit
On the 1st January a volley of tax-rises and spending cuts will hit nearly every American in the USA, and could potentially cause devastation to the already weak economy, unless Congress takes action to cancel them.
Iran is another source of headache for the president, ensuring stability in Iraq and promoting a solution to the Israel/Palestine situation, fighting terrorism, ensuring open access to energy and preventing a nuclear war are also all on Obama's to-do list. The US remains determined to prevent Iran gaining a nuclear weapon, however Iran maintains its nuclear program is solely peaceful and its leaders refuse to back down.
4. Medicare costs