> Download as a PDF ANNA joins the nursing community in commending the work of the House of Representatives and Senate to reform Americas health care system. This legislative effort represents a movement towards comprehensive and meaningful change that will improve access to quality care. This letter outlines the requests of the nursing community as the House and Senate negotiate the differences between the Houses Affordable Health Care for America Act of 2009 (H.R. 3962) and the Senates Patient Protection and Affordable Care Act (H.R. 3590).