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The healthcare reform led to the introduction of the Affordable Care Act (ACA) which led to the massive gain of insurance cover by many people. The healthcare reform is seen to be having a positive impact on primary care to the citizens. However, there was also a general increase in the demand for primary care physicians. The primary care provider workforce, however, is diminishing as compared to the increasing primary care demand. This was addressed by growing emphasis on nurse practitioners which have seen a growth rate in the graduation rates of nurse practitioners. Most of the nurse practitioners are prepared to offer primary care but are faced with problems such as the scope of practice regulations issued by the respective regulatory bodies. To deal with the problem more states are working to increase the scope of nurse practitioners’ roles to increase the number of primary care providers (Sophia, 2016).The affordable care act (which is commonly referred to as Obama care)affects individual choices on insurance buying and adds a tax penalty to anyone who does not purchase a qualified health insurance plan. Premiums of the ACA plans have generally increased since its inception and the government is currently offering subsidies to lower the insurance cost to those who are qualified. It is observed that the young and healthy are not buying the ACA compliant policies but instead go for the cheaper non-compliant policies. Those on a pre-ACA plan are not protected from their ACA and their plans may be canceled at any time. Plans are renewed every year but for ACA plan premiums increased as from the first of January the year two thousand and eighteen. Christian medi-share is a great alternative to individuals who find affordable care act expensive and the plan is also ACA compliant(Corry, 2017).Healthcare transformation is driven by access problems, disparities, unsustainable costs and, others. Quality and cost were the main reasons that necessitated change and the Affordable Care Act was created to improve quality while maintaining low care costs. Nurses have earned a position to lead and contribute to the transformative changes occurring in healthcare. The drivers of change are listed as cost, quality, waste, healthcare disparities healthcare system infrastructure and, variability, and lack of standardization. To make healthcare safer and of quality, some principles were suggested which included: patient-centered, safe, effective, timely, efficient and, equitable. Nurses were also tasked with new tasks in the new healthcare reforms: focusing on wellness, patient and family-centered care, care coordination, data analytics which include a focus on outcomes and improvement and, moving forward(Salmond et al., 2017).ReferencesSophia, B. (2016). How Healthcare Reform Is Impacting Primary Care. Retrieved fromhttps://www.ajmc.com/view/how-healthcare-reform-is-impacting-primary-careCorry, N. (2017). Healthcare Reform 101: What the Health is Going On in 2018?! [Video file] retrieved fromhttps://youtu.be/cwTWhwWLzHQSalmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic nursing, 36(1), 12.