Ginna Betts chaired the ANA Presidential Endorsement Taskforce and guest authors today’s Capitol Beat Blog to provide her perspective into ANA’s move to a Presidential Engagement process.
The 2020 U.S. Presidential election cycle is one that is generating strong opinions and even stronger feelings from every corner of the United States. The American Nurses Association (ANA) has not been exempted from the fervor as, notably, for the first election cycle since 1984, ANA chose not to endorse (based on a 2019 Membership Assembly (MA) decision) a presidential candidate. For those members who may not have been following ANA’s internal policy processes closely and for others who (like me) have always highly valued ANA’s political and policy leadership roles, let me catch you up on how the Association reached the decision in 2019 to not continue endorsing in presidential elections and then describe what ANA would like YOU, our politically active and passionate members, to do: ENGAGE.
Since the 1988 presidential election, the ANA Political Action Committee (PAC) and the ANA Board (BOD) have implemented a rigorous process to select then endorse a candidate for the president of the USA. Presidential endorsements were followed by ANA encouraging and facilitating its membership to participate in political events in support of the endorsed candidate. Making the candidate selection and then advocating for ANA’s choice has always been fraught with controversy— especially when ANA’s endorsed candidate did not win the election. Letters to the ANA President and BOD with threats to drop memberships seemed to lessen (but not totally) when ANA endorsed winning candidates (such as Clinton/Gore and Obama/Biden). The upside of the endorsement of winning candidates was that nurse leaders were named to key posts in the federal government; ANA increased its presence at the national policymaking table; and ANA’s policy agenda and professional principles were imbedded in US executive policy initiatives. That upside was certainly my own experience as ANA president 1992-1996!
However, the political climate in the Nation has changed enormously and has rapidly become more and more contentious and polarized. Political campaigns have become wildly expensive. All of these variables are difficult to manage in the context of a professional association of members who hold widely diverse political views and a PAC whose coffers are limited. Even as the 2016 PAC Board voted unanimously to recommend the endorsement of Secretary Hillary Clinton for president with her long history of support for ANA, nursing, and health care, there was angst within the PAC about whether or not endorsement was the best way forward for the Association. The PAC debated many complex questions and concerns about the impact of endorsement of any presidential candidate, then elevated the issues to ANA’s BOD and Membership Assembly (MA). The 2018 MA held a comprehensive Policy Dialogue that included a report on the Association’s history of endorsement and outlined the current political environment after which the endorsement issue was sent back to the ANA Board of Directors for development of a definitive proposal urging in-depth exploration of multiple factors.
In the Summer of 2018, Pam Cipriano, ANA’s then president, appointed an eleven member Task Force (TF) on ANA’s Presidential Endorsement policy and process and (knowing of my unwavering belief in and commitment to nursing, policy, and political action) asked me to chair. The TF was charged to study ANA’s Presidential Endorsement process, its implementation, and its impact over more than a two-decade period and to submit a report to the BOD with recommendations. The TF was comprised of a geographically diverse group of politically engaged nursing leaders holding varied personal and political perspectives, and we were charged to serve the interests of ANA and its entire membership utilizing our political and policy passion and savvy.
The TF studied numerous ANA political and policy materials developed over time; held robust discussions and debates; engaged in rich conversations with external consultants to seek a keen understanding of professional associations’ best practices in their political activities; and sought input from Constituent/State Nurses Associations and ANA members across the United States. From our expert consultants, we became aware of some very important facts that certainly weighed heavily in our deliberations and recommendations. Included among these: (1) the impact of the advent of vast amounts of unregulated money into U.S. politics post the Supreme Court Citizens United case; (2) current candidates are more likely to seek significant financial contributions than other kinds of support; (3) increasingly, candidates did not respond to ANA’s questionnaires or agree to interviews by the PAC; (4) all of our other peer non-unionized health professional associations do not endorse presidential candidates; (5) membership surveys indicated that ANA’s membership over time had become more evenly balanced between the two major political parties; and (6) ANA can take positions on policy and political issues without endorsing a particulate candidate.
As a TF, we sought a way to have ANA and nurses participate in the presidential election process that was both relevant and doable in today’s complex and ever-changing political environment. Thus, the TF considered the pros and cons of (1) continuing with the historic endorsement process; (2) modifying endorsement activities; and/or (3) proposing an alternate approach to presidential election activity. The TF chose the latter and brought our preliminary recommendations to the BOD in December 2018 and a final report in Spring 2019 for consideration, review, feedback, and action.
Our recommendation was that ANA move away from presidential endorsement and adopt a policy of strong ANA supported political engagement during each presidential election cycle. We very much wanted to encourage ANA’s membership and all 4.2 million nurses throughout the USA to VOTE and be supported to fully engage in political activism for their candidate of choice. We saw ANA assuming a vital leadership role in the political arena by equipping professional nurses with accurate and current information about the candidates’ relevant positions and statements; the political parties’ platforms; and importantly how each candidate compared to ANA and nursing’s principles, positions, and policies. Prior to the MA vote, the TF and ANA hosted a webinar reviewing the TF’s work followed by an onsite MA forum held prior to official membership action. The debate at the 2019 MA was robust, positive, and transparent. Elected MA representatives were focused on making an informed, future-focused decision that would position ANA to be successful with its entire advocacy agenda. By an 87% positive vote, the Presidential Engagement policy replaced the Presidential Endorsement policy. The policy then moved forward for implementation just as the 2020 election “season” begin to heat up.
Then… a perfect storm that stoked more anxiety, controversy, and angst. The first iteration of Presidential Engagement IMPLEMENTATION is occurring during a time of a global pandemic posing a significant threat to nurses and their families; a national reckoning with racism as a second national public health crisis; heightened hyperbolic political rhetoric and a presidential impeachment; and significant city and street protests/and violence. This unprecedented time in history that will call for a deliberate review of what worked, what did not work, and what the ANA Presidential Engagement policy should look like when we get back to what will be a “new normal.”
TODAY, I think we all agree that this year’s elections are among the most consequential in our lifetimes calling for every nurse to consider engaging in the political process. Just as we together are celebrating the 100th anniversary of the 19th Amendment granting women the right to vote; the WHO Year of the Nurse and Midwife; and Florence Nightingale’s 200th birthday, we can also do so much together with other nurses to be politically engaged.
You may have seen that I, along with seven of my past president colleagues, have embraced ANA’s Presidential Engagement process to support the candidate we believe most aligns with our political views [LINK]. We made our choice by comparing ANA’s policies, principles, and values to the candidates’ past positions and actions.
The eight of us are working tirelessly to get our chosen candidate elected. We are working with the media. We are using social media. We are organizing nurse activists in the battleground states to work with their media partners, to participate in outreach work with other nurses, and to share nurses’ beliefs with their members of their communities. Please join us in engaging nurses to VOTE and to speak out about what nursing stands for and what nurses need. By doing so, ANA and the nursing profession will be stronger, more powerful, and more valued for years to come. With over 4.2 million nurses in the United States – our engagement can make an impact in this coming election. I encourage each of you to actively participate in the political process.
Thank you. I hope to see you on the campaign trail!
Virginia (Ginna) Trotter Betts, RN, MSN, JD, FAAN
ANA Past President 1992-1996
Task Force Chair on Presidential Endorsement Policy
ANA maintains neutrality in the presidential elections. The views expressed in this blog post do not necessarily reflect ANA’s.