Congressional Action in December


Lame Duck Watch

Now that the midterm elections have passed, the 115th Congress has entered its biannual period referred to as a “lame-duck” session. Some lawmakers who return for the lame-duck session will not be in the next Congress because they are retiring or lost their reelection. For that reason, they are referred to as lame-duck members. Lame-duck sessions are never predictable and can occasionally lead to high stakes drama. Here are a few issues we’re taking note of as the lame-duck gets underway.

Government Funding

Yesterday, President Trump threated to shut down the federal government if Congress does not give him $5 billion to build a wall on the U.S.–Mexican border that he campaigned on. Democrats have only agreed to $1.6 billion in funding. If Congress doesn’t pass seven appropriations bills by December 7, nonessential operations at multiple federal agencies will come to a halt due to a lack of funding.

Senate Appropriations Committee Chairman Richard Shelby has stated that a one-year continuing resolution (CR) is likely unless negotiators make significant progress on an agreement on border wall funding by next week, but did not rule out another short-term CR if there is some progress.

A continuing resolution funds the government at the same levels as the previous fiscal year for a set amount of time. Many Republicans would prefer a one-year CR be completed before Democrats take control of the House next year, rather than risk a shutdown which could give Democrats leverage in appropriations negotiations.

Title VIII

Senate Health Education Labor & Pensions Committee Chairman Lamar Alexander announced that there would not be another markup for the Committee this year. This means that Title VIII reauthorization will not happen in 2018. It’s a very unfortunate development after the House passed reauthorization unanimously on a voice vote in July. ANA and the Nursing Community Coalition will continue to fight for this long overdue reauthorization.

ANA-PAC’s Success in the 2018 Mid-Term Elections


It’s clear that the November 6th midterm elections were a successful day for the nursing profession and health care more broadly. The American Nurses Association Political Action Committee (ANA-PAC) paid dividends for its members and the profession by spending more than $422,000 to help elect longstanding champions of nursing like Reps. David Joyce (R-OH-14) and Frank Pallone (D-NJ-6), as well as Sens. John Barrasso (R-WY) and Tom Carper (D-DE) while helping usher in fresh faces for the 116th Congress like Rep. Elects Joe Morelle (D-NY-25) and Dusty Johnson (R-SD-At-Large).

Rep. Elect Morelle has collaborated with the American Nurses Association-New York during his time in the state assembly and consistently helped secure legislative victories to advance the nursing profession, including passage of a bill that strengthens education requirements for future nurses and establishing a commission to evaluate and report on barriers to entry into the nursing profession in New York while Rep. Elect Johnson was responsible for overseeing the South Dakota State Employee Health Care Plan in his capacity as chief of staff to Governor Dennis Daugaard, where he heard and implemented input from health care professionals across the state, including nurses. He is dedicated to bringing stability to a health care market that has experienced a great deal of uncertainty in the past year and a half.

On a particularly great note, registered nurse Lauren Underwood achieved victory as the next Member of Congress representing the Illinois 14th congressional district. Besides being a fellow nurse, she also earned the distinct honor of being elected the first congresswoman from her district. Lauren will join registered nurses Reps. Karen Bass (D-CA-37) and Eddie Bernice Johnson (D-TX-30) in the 116th Congress.

If there was ever any proof ANA knows how to support the correct candidates it’s this: of the more than 120 candidates for federal office supported by ANA-PAC, an impressive 94% have won their election. A total of 96% of incumbents, 91% of those running in open seats and 90% of candidates running against a sitting federal lawmaker won their elections while 93% of those candidates the PAC endorsed were elected. This showcases ANA staff’s ability to identify candidates who are both invested in moving nurses forward and are likely to run successful campaigns that are responsive to their voters’ broader interests, including the need for increased access to affordable health care.

Not surprisingly, ANA staff are already evaluating the political landscape on Capitol Hill and strategizing for the 116th Congress. A Republican-controlled Senate and a Democratic-controlled House is just one of the many factors being considered in terms of how best to advance ANA’s legislative and regulatory agendas. Whether the issue is safe staffing, nursing scope of practice or safe patient handling, staff are determined to find new ways to build and enhance bipartisan support of our issues.

This cycle, ANA’s members helped the ANA-PAC achieve and exceed its fundraising goal by raising more than $500,000 since January 1, 2017 (remember: no ANA dues money is ever used to support political candidates). Staff, along with the ANA-PAC Board of Trustees, will be utilizing these contributions to continue cultivating relationships on both sides of the  political aisle, and maintaining our non-partisan presence on Capitol Hill. Stay tuned to Capitol Beat for more updates as the legislative agenda for the 116th Congress develops.

To learn more about ANA-PAC, check out of FAQs and see who the PAC supported in your state please check out the ANA-PAC website.

A historic midterm delivers a complicated path forward on health care


An extraordinary 114 million voters cast ballots Tuesday and delivered the House of Representatives back into the hands of the Democratic party, while voters in more conservative states chose to oust several Democratic incumbents to ensure that the Senate remains under Republican control for the 116th Congress. While some races have yet to be called, turnout was the highest it’s ever been for a midterm election, and the outcomes ensure that lawmakers will have to find a way to reach bipartisan consensus to achieve any meaningful health policy outcomes before the next national election in 2020.

In the Illinois 14th congressional district, registered nurse Lauren Underwood successfully unseated her incumbent opponent, ensuring that the 116th Congress will benefit from the perspective and insights of a member of America’s most trusted profession. Endorsed by ANA-PAC, Underwood focused her campaign messaging on the need to improve health policy and is likely to make it a major component of her agenda once in office.

Similarly, Democratic candidates across the country put health care at the center of their campaigns, and the new House majority is widely expected to tackle issues like market stabilization once the 116th Congress convenes, as well as other measures to shore up the Affordable Care Act (ACA). As with all issues in the new Congress, getting a bill on the President’s desk for signature will require bipartisan cooperation with Sen. Mitch McConnell (R-KY) and his now expanded majority.

Despite uncertainty around how fruitful any such cooperation might be, divided control of Congress ensures that any subsequent attempts to repeal and/or replace additional elements of the ACA will be dead on arrival, particularly given the prominence of protecting patients with pre-existing conditions in Democratic campaign messaging. House Democrats will also likely consider legislation to bring back the ACA’s mandate that individuals attain health coverage, which was eliminated in the tax package congressional Republicans passed late last year.

While more progressive candidates tended to focus on the need for a single-payer health care system, most commonly referred to as Medicare for All, this approach will be a non-starter in the Republican Senate, increasing the likelihood that more incremental reforms will be the focus on Capitol Hill. Despite this, single-payer proponents will continue to push both incumbent lawmakers and those who challenge them on the left to embrace Medicare for All, in the hopes of eventually electing a Congress that can pass it.

In post-election press conferences, both President Donald Trump and current Democratic Minority Leader Nancy Pelosi (who is widely expected to attempt to regain the title Speaker of the House) indicated that they would seek to find common ground on a number of issues, including legislation that would reduce prescription drug costs, though details on how to accomplish this shared goal are unclear.

On the ballot initiative front, three states voted to do what their governors and state lawmakers had so far refused to do: expand access to Medicaid. Voters in Idaho, Nebraska, and Utah all approved measures to allow adults and their families to receive coverage via this federal program. States will now be required to submit a State Plan Amendment that outlines how they will implement these programs, with deadlines arriving either in early March or April of next year, depending on the state. Other states that have held off on Medicaid expansion are likely to consider similar initiatives going forward.