Review of the literature on health reformAccording to Ehlke (2009), Buerhaus, Ulrich, Donelan and DesRoches (2008), health insurance and the system Health care in America has become an overly politicized arena. Some authors such as Healy (2010) believe that the current healthcare system is a highly subjective political position designed to benefit a privileged few while the majority will suffer the heavy burden of higher premiums. It is undeniable that the health system needed urgent changes (Guevara and Mendias, 2002). Nevertheless, improving health care needed to be a comprehensive and inclusive endeavor, taking into account all parties involved without oppressing any one party (McLaughlin, 2005). Different institutions reacted to the Affordable Care Act, which was also branded Obama Care (Ellerbe and Regen, 2012; Healy, 2010; McLaughlin, 2005; Gibson and Singh, 2011). In the nursing profession, the Affordable Care Act (ACA) has received mixed reactions and issues that tend to conflict with the nursing profession (Ellerbe and Regen, 2012). Ellerbe and Regen note that while the ACA has a set of important implications, the nursing profession is increasingly a competitive environment that “emphasizes the importance of positive patient outcomes” (p. 210 ). The challenge comes from consumers (patients) who have learned the quality of service expected from healthcare providers (Arah, Klazinga, Delnoij, Ten Asbroek, & Custers, 2003; Ellerbe & Regen, 2012). This tends to increase pressure on the nursing profession, particularly with the increase in health insurance coverage (Arah et al., 2003; Ellerbe & Regen, 2012). The basic concept of the ACA was to ensure that middle- and low-income earners will be able to afford health care...... middle of document ......arch, 35(3), 663-686. McLaughlin, C. (2005). Health care reform and health services research: What was once old is always new. Health Services Research, 40(3), 599-604. doi: 10.1111/j.1475-6773.2005.00376.xPan American Health Organization (1998). Health in the Americas. Volume Two. Washington, everything. Geneva: WHO. Shaban, R., Brandenburg, E. (2012). Nursing research: methods, critical evaluation and use '2nd ed. Schneider, Z., Elliott, D., (editors) LoBiondo-Wood, G., Beanland, C. and Haber, J. (editors) Mosby – Elsevier; 2004. ISBN: 0-7295-3665-3. Australian Journal of Paramedicine, 3(3), 1-3. Retrieved from http://ro.ecu.edu.au/jephc/vol3/iss3/9Tshannen, D., Keenan, G., Aebersold, M., Kocan, MJ, Lundy, F., & Averhart, V. (2011 ). Implications of nurse-physician relationships: Report of a successful intervention. Economic Nursing$, 29(3), 127-135.