Describe a federal health care reform initiative undertaken in the past decade. It may be the Patient Protection and Affordable Care Act or another federal reform. Describe what this reform initiative is, the intent of this initiative, and the current state of federal reform.

Broadly describe how this federal health care reform initiative has been implemented in your state of residence.

Then provide an in-depth description of one state-level reform emanating from the federal reform initiative that you have selected. Address how this state reform initiative has impacted your state's health care delivery system in regards to cost and access to both health and public health services.