Category: Congress

New Year, New Congress and Administration, Same Mission.

  

The American Nurses Association (ANA) continues to advocate on behalf of the nation’s nearly 5 million registered nurses (RNs) to federal policymakers. With a new Congress and Administration comes change and a level of uncertainty. However, our priorities remain centered around the following goals: building and preserving a robust nursing workforce; improving health care outcomes and access; removing practice barriers for advanced practice registered nurses (APRNs); shaping payment strategies to account for the direct impact of nursing care; preserving the relationship between nursing and public health; and utilizing health care technology appropriately. 

We detailed these priorities and positions in a letter to Congress, sent to both Senate and House leadership. For our regulatory advocacy, ANA’s Policy Team has crafted a priorities document to share with internal and external stakeholders and policymakers and recently sent a letter to Secretary Kennedy.

Building and Preserving a Robust Nursing Workforce 

We believe that federal policymakers must take action to address current workforce challenges and ensure the health care workforce is able to meet future challenges by protecting our nurses and creating healthy work environments. We continue to call on Congress to address workplace violence for nurses, as well as limit mandatory overtime. Congress must take action to improve nurse staffing and reduce burnout, such as investing in mental health and substance use dependence support for nurses. Additionally, we encourage HHS to engage with nurses to implement measures that will protect a robust nursing workforce, address the current nursing shortage, and make the workplace safer for nurses.  

Ensuring a robust nursing workforce requires new, well-trained nurses. We urge Congress to invest in nursing education to ensure that a new generation of nurses are ready to work in the changing health care landscape. Investments in nursing education and recruitment will attract more nurses, nurse faculty, and nurse preceptors.  

Improving Health Care Outcomes and Access 

ANA believes that all people in America deserve access to high quality health care and care options. One area where ANA is working to improve health care outcomes and access is in the field of maternal health—working with Congress to enact legislation to expand the perinatal nursing workforce to ensure that women have access to the perinatal care they need and recommending that HHS keep nurses central to addressing maternal health challenges. Additionally, we are currently working with allies in the health care community to defend Medicaid to ensure that our most vulnerable patient populations have access to health care providers, such as trusted nurses.  

Removing Practice Barriers for APRNs 

We believe that removing practice barriers for advanced practice registered nurses (APRNs) will promote quality care and help provide proper payment for nurses. We encourage HHS to issue rulemaking to implement provider nondiscrimination protections, while urging the Centers for Medicare & Medicaid Services (CMS) to use its administrative authority to remove regulatory barriers to APRN practice in Medicare. Bolstering access to APRNs only serves to increase health care access, especially for our most vulnerable patient populations.  

Additionally, we are actively engaging members and other stakeholders to urge Congress to pass the bipartisan Improving Care and Access to Nurses (ICAN) Act to permanently remove longstanding Medicare and Medicaid restrictions that limit Advanced Practice Registered Nurses (APRNs) from practicing to the full extent of their education and clinical training. By addressing these barriers, the ICAN Act will enhance access to essential health care services, particularly in rural and underserved communities. We encourage our members to take action and show support for the ICAN Act. 

Shaping Payment Strategies to Account for the Direct Impacts of Nursing Care 

At ANA, we understand just how essential APRNs and RNs are to the provision of patient care and how they deserve fair compensation for the services they provide. We call on HHS to support CMS in taking regulatory and administrative steps to account for nursing care under Medicare and Medicaid payment methodologies and to align reimbursement and quality rewards with the provision of high-value nursing care. Additionally, ANA is ready and willing to engage with Congress on future efforts or roundtables to reform parts of the Medicare payment system. 

Preserving the Relationship Between Nursing and Public Health 

The COVID-19 pandemic demonstrated how intertwined the fields of nursing and public health are. We stand firm in our position that HHS must continue to promote vaccinations, in order to protect nurses and their patients, as well as to relieve overburdened health systems. ANA knows how important federal medical research and its impacts are for nurses leading research, the provision of health care, and the nursing profession. Additionally, we continue to underscore to HHS the importance of international relationships and partnerships in public health preparedness and have stressed the need to keep federal government public health datasets accessible.  

Utilizing Health Care Technology Appropriately 

New technologies can be used to improve health care outcomes and access, but they must be used ethically. ANA believes that HHS must investigate how artificial intelligence (AI) can best be used in the medical and health spaces, while underscoring how critical it is that AI should neither substitute licensed practitioners, nor should it be the only diagnostic tool that practitioners use. At the same time, we want to see HHS promote the use of telehealth to increase access to health care, especially to increase access to care in rural areas. Currently, there is a proposed rule on special telehealth registration from the Drug Enforcement Agency (DEA), and ANA has advocated for HHS to lead efforts to encourage the DEA to revisit their proposed rule and to issue a new rule that better reflects the needs of APRN practice. Additionally, we are working with allies to advocate for the permanent extension of telehealth flexibilities.

Looking at the Year Ahead 

A new Congress and Administration provides ANA with new opportunities and challenges to advance our priorities and to advocate for our members. ANA is ready to work with the 119th Congress on improving health care delivery and advancing the nursing perspective. We will seek common ground with the new Administration, so that we can continue to advance the nursing profession and the wellbeing of America’s nurses. As always, ANA stands ready to respond to emerging policy issues that impact nurses and their patients, while remaining steadfast in our mission to lead the profession to shape the future of nursing and health care. 

ANA’s Advocacy before the August Recess – Q2 Legislative Roundup

  

Ahead of the congressional recess in August, the American Nurses Association has been hard at work advocating for the profession on Capitol Hill.

Here is what you need to know: 

The House Appropriations Committee recently advanced its Fiscal Year (FY) 2025 Labor, Health and Human Services, and Education (LHHS-ED) bill. The bill proposes an $18.343 million decrease in funding to the Title VIII Nursing Workforce Development Programs, elimination of the Nursing Workforce Diversity Program, and the elimination of the National Institute of Nursing Research (NINR) as part of a proposed restructuring of the National Institutes of Health (NIH).

ANA and its allies in the nursing community continue to urge Congress to appropriate at least $530 million to the Title VIII Programs and at least $210 million to NINR. 

In other news, the House Education and Workforce Committee recently advanced the Improving Access to Workers’ Compensation for Injured Federal Workers Act (H.R. 618). The bill would eliminate outdated barriers in the Federal Employees’ Compensation Act (FECA) that limit the ability of nurse practitioners (NPs) to provide care and treatment for injured or ill federal employees. HERE is the letter that ANA submitted to the committee ahead of the markup. 

ANA engaged Congress in a variety of other ways throughout the second quarter of 2024: 

Establishing Long-Term Care Staffing Standards

ANA recently submitted a letter to House and Senate Leadership that urges Congress to oppose ongoing efforts on Capitol Hill to overturn the Centers for Medicare and Medicaid Services’ final rule that would establish safe staffing standards in long-term care facilities. The final rule was issued by CMS in April. The House Ways and Means Committee passed HR 7513 in March to prevent the implementation of the rule, and a pair of resolutions (HJ Res. 139 / SJ Res. 91) were introduced in May that would fast-track the process for overturning the final rule pursuant to the Congressional Review Act. 

Improving Access to APRNs

ANA recently sent a letter to the Senate Finance Committee that highlights ways that Congress can ensure Medicare patients’ access to nursing care through Medicare Part B Payment Reform. 

ANA recently submitted a letter to Senators Sheldon Whitehouse (D-RI) and Bill Cassidy, MD (R-LA) that highlights how Congress can expand Medicare patients’ access to primary care services provided by APRNs. In the letter, ANA calls on Congress to reform how CMS determines reimbursement rates for APRNs and ensure that nurses have a seat at the table when those decisions are made. 

Improving Care and Access to Nurses Act (ICAN) Congressional Briefing

ANA co-hosted a congressional briefing with American Association of Nurse Anesthesiology (AANA), the American Association of Nurse Practitioners (AANP), and the American College of Nurse-Midwives (ACNM) to bring awareness of the Improving Care and Access to Nurses (ICAN) Act (H.R. 2713/S. 2418) and its effort to remove regulatory barriers that Medicare patients face when attempting to see advanced practice registered nurses (APRNs). 

Minority Fellowship Program Congressional Briefing

ANA participated in a congressional briefing with the American Psychological Association, the American Psychiatric Association, and the National Board for Certified Counselors to commemorate the 50th anniversary of the Minority Fellowship Program (MFP). Administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), the MFP provides training, career development, and mentorship to mental health professionals from minority and ethnic backgrounds who are dedicated to serving patients of color and other marginalized communities. 

ANA Builds Momentum on Nursing Priorities on Capitol Hill

  

During the first quarter of 2024, the American Nurses Association’s Policy & Government Affairs Department collaborated with lawmakers on Capitol Hill on several legislative priorities. Here is a highlight of several initiatives that aim to rebuild the nursing workforce and address work environment challenges facing the nursing profession. 

ANA Responds to Problematic Staffing Bill 

The House Ways and Means Committee recently approved the Protecting America’s Seniors’ Access to Care Act (HR 7513), which would prohibit the U.S. Centers for Medicare and Medicaid Services (CMS) from finalizing its proposed long-term care safe staffing regulation.  

ANA sent a letter to House Leadership expressing its concerns about the bill’s adverse impact on the nursing workforce and the importance of ensuring safe staffing in long-term care facilities. ANA urged Congress to work with the Administration and stakeholders to find a balanced approach to addressing healthcare workforce challenges. It remains to be seen whether House Leadership brings the bill to the floor. Thankfully, the bill is dead on arrival in the Democratic-controlled Senate. 

ANA Co-Hosts Workplace Violence Briefing on Capitol Hill 

On March 22, ANA co-hosted a congressional briefing on workplace violence in emergency departments along with the Emergency Nurses Association and the American College of Emergency Physicians. Katie Boston-Leary, Director of Nursing Programs at ANA, represented ANA’s perspective on workplace violence in healthcare, its adverse impact on the nursing workforce, and potential solutions for addressing the crisis. 

 Congress Acts to Provide Mental Health Support for Health Professionals 

The House Energy and Commerce Committee recently voted to approve H.R. 7153, a bill that would reauthorize the Dr. Lorna Breen Health Care Provider Protection Act to provide mental health support to healthcare professionals. A companion bill, S. 3679, is pending in the Senate. On that same day, the U.S. Senate passed Senate Resolution 567 to recognize March 18, 2024 as the inaugural “Health Workforce Well-Being Day of Awareness.” A companion resolution is pending in the House (H. Res. 1089). 

Congress Invests to Attract More Registered Nurses 

Congress recently approved appropriations legislation to fund the federal government through the remainder of Fiscal Year 2024, which ends on September 30, 2024. While most of the Title VIII Nursing Workforce Development Programs and the National Institute of Nursing Research received static funding, Congress approved an increase of $5 million for Title XIII’s Nurse Education, Practice, Quality, and Retention Program for grants to increase the supply of registered nurses, specifically in long-term and acute care settings and in states having the greatest shortages. 

ANA Advocates for National Standards at the VA  

The House Veterans’ Affairs Committee held an oversight hearing to examine veterans’ access to healthcare services in rural settings through the U.S. Department of Veterans’ Affairs. ANA submitted a statement for the record, urging the VA to develop national practice standards for certified registered nurse anesthetists (CRNAs) that allow them to practice at the top of their license wherever they are needed within the VA health system. 

Lawmakers Introduce Bill to Restrict Mandatory Overtime for Nurses 

A bipartisan group of lawmakers in both chambers recently introduced the Nurse Overtime and Patient Safety Act (H.R. 7546/S. 3860). This bill would restrict the use of mandatory overtime for nurses with exceptions for federally-declared emergencies. The bill also includes whistleblower and nondiscrimination protections, transparency requirements, and civil penalties. The bill would require the Agency for Healthcare Research and Quality (AHRQ) to conduct a study on standards for safe working hours and the use of mandatory overtime. 

House Introduces Legislation to Attract Nurse Faculty 

The House recently introduced the Nurse Faculty Shortage Reduction Act (H.R. 7002), which would allow nursing schools to apply for grants from the Health Resources & Services Administration (HRSA) to supplement the difference between what faculty nurses are paid versus what equally trained nurses in clinical practice earn. It is bipartisan and was introduced in the Senate over the summer. 

Congress Reintroduces Measure to Support Nursing Workforce Pipeline 

The Future Advancement of Academic Nursing (FAAN) Act (H.R.7266/S.3770) was reintroduced in Congress. This legislation calls for critical investments to address immediate nursing education needs, while providing proactive measures to meet future workforce demands, including enrolling and retaining nursing students; hiring and retaining a diverse faculty to educate the future nursing workforce; support schools of nursing in partnership with healthcare facilities, to establish or expand clinical education; and to modernize educational infrastructure.