This chapter examines the impact of the Affordable Care Act (ACA) and the Institute of Medicine (IOM) report on nurse-managed care and provides an overview of what has happened since 2010, and looks at some ways these documents are expected to advance nurse-managed care in the future. The ACA’s support of nurse-managed health clinics (NMHC) was not an accident; it was the result of a prolonged advocacy campaign. The federal government enacted a series of laws aimed at countering what was then a growing nursing shortage. National nursing centers consortium (NNCC) found that very few legislators understood the NMHC model or what nurse practitioners (NP) and other advanced practice nurses (APN) were capable of doing. Therefore, the organization’s policy staff began by raising awareness of NMHCs and promoting the recognition of NPs in state law.