Category: Nurse Advocacy

President Biden Releases $1.9 trillion COVID-19 Relief Plan

  

On January 14, President Biden’s transition team unveiled the administration’s first COVID-19 relief plan—the American Rescue Plan. The $1.9 trillion plan would roll out in two steps: rescue and recovery.

The President’s plan is broadly aimed at shoring up the economy, but the proposal does address workforce issues of particular interest to nurses and other frontline health care workers, as well as teachers. President Biden is calling on Congress to provide $350 billion in emergency funding for state, local, and territorial governments to ensure their ability to keep front line public workers on the job. A key selling point for this aid is that it would bolster state capacity to effectively distribute COVID-19 vaccines, scale testing, reopen schools, and maintain other vital services.

In order to address health care coverage needs of patients, President Biden is calling on Congress to subsidize continuation health coverage (COBRA) through the end of September. The plan also directs Congress to expand and increase the value of the Premium Tax Credit to lower health insurance premiums and set a cap of no more than 8.5 percent of patient income for coverage.

Tragically, mental health issues and substance use disorders continue to be major consequences of the pandemic for many people, including frontline health care workers and first responders.  President Biden has called on Congress to appropriate $4 billion to enable the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration to expand access to services for more Americans.  ANA supports these broader mental health investments, as well as targeted efforts to address nurses’ mental health.

Acknowledging the economic hardships brought on by the pandemic, the plan includes $1,400 in additional direct aid for those with incomes below $75,000 and $400/week in enhanced unemployment insurance payments. The plan also includes funds for state work-sharing programs and would continue the moratorium on evictions through September 2021 for those struggling to pay their rent or mortgage. The plan would allocate $5 billion for combatting homelessness, provide a 15 percent increase in Supplemental Nutrition Assistance Program benefits, and a $3 billion increase in Special Supplemental Nutrition Program for Women, Infants, and Children. The plan also proposes to raise the federal hourly minimum wage to $15 per hour.

In addition to including benefits for the unemployed and underemployed, the proposed plan would provide hazard pay—going forward and retroactively—to essential workers who have taken on extra risk during the pandemic by working on the front lines. ANA supports recognition of frontline health care workers and continues to advocate for hazard pay for the nurses integral to combatting the COVID-19 pandemic.  Additional support for families includes $25 billion for child care centers, expansion of child care tax credits and the Earned Income Tax Credit, and $1 billion in cash assistance for Temporary Assistance for Needy Families programs.

Last, President Biden is calling on Congress to allocate $3 billion for the Economic Development Administration (EDA). Grants from EDA provide resources directly to state and local government entities, tribal institutions, institutions of higher education, and non-profit organizations to fund initiatives that support localized economic development. This funding—double the amount provided by the CARES Act last year—would support the broad range of financial needs in communities across the country as they continue to respond to and recover from the COVID-19 pandemic.

As Congress and the administration work to see the policies contained in the American Rescue Plan signed into law, ANA continues to work with lawmakers to address the needs of nurses and patients in more targeted ways. ANA’s legislative agenda calls for specific steps to address nurses’ mental health needs, provide hazard pay, institute a moratorium on nurses having to use paid time off when they contract COVID-19, and investing the public health infrastructure and workforce.

Large health care investments cap off eventful 2020 as we look ahead into 2021

  

What a historic year it has been on so many levels. Leaving behind the first year of a new decade that saw struggles which we could not have foreseen in January 2020, and going into a holiday season that looks vastly different from years passed and a future that is still unclear – it’s easy to focus on the negative. However, despite the trials and tribulations of this year, it is important and inspiring to recognize all of the ground-breaking work that ANA and nurses have done in the policy, government affairs and advocacy spaces, as we look towards what is on the horizon in 2021.

At the time of publication, Congress is in the process of passing a year-end package that will avert a government shutdown, include money for vaccines and COVID-19 aid to frontline workers, boost the economy, and include language to protect patients from surprise billing for health care. ANA has been working with our allies in Congress, and advocating to get these items addressed. Please be on the lookout for further details on the year-end package by visiting ANA’s new advocacy page. In the meantime, let’s acknowledge the progress made throughout 2020, which was necessitated by the COVID-19 public health emergency (PHE).

Earlier this year, the U.S. Congress and the President signed into law the Coronavirus Aid, Relief, and Economic Security (CARES) Act. Included in the law is language that reauthorizes Title VIII Nursing Workforce Development Programs and authorizes Nurse Practitioners (NPs) and Clinical Nurse Specialists (CNSs) to order home health care for their patients. These are longtime ANA federal legislative priorities, and we applaud Congress and the administration on their passage in the early stages of the pandemic. Advanced Practice Registered Nurses (APRNs) like NPs and CNSs are key to COVID-19 care and maintaining access to non-COVID-19 care throughout the crisis.

By summer, ANA was becoming a regular voice for nurses as Congress sought additional solutions to PHE challenges in the healthcare system. ANA President Ernest Grant testified at a hearing before the Senate Finance Committee, “Part 2: Protecting the Reliability of the U.S. Medical Supply Chain During the COVID-19 Pandemic.” Dr. Grant was there to answer the many questions Senators had about the impact of COVID-19. Questions ranged from what more the federal government could do to strengthen the supply chain, to the needs of nurses on the ground.

ANA also responded on behalf of nurses to proposals outlined in a white paper released by the Senate Health, Education, Labor, and Pension (HELP) Committee. The Committee requested input on what the U.S. had learned from the past 20 years of public health preparedness and response, and how we can better prepare for future pandemics. ANA’s response focused on how to rebuild and maintain state and federal stockpiles, improving public health capabilities, and increasing medical supply surge capacity and distribution. 

ANA has been consistently present with effective advocacy on personal protective equipment (PPE), which has been in short supply all year. As a result, the enterprise was tapped as leadership of a broad-based the coalition that will be a united voice to Congress and the administration on PPE and supply chain issues, to improve public health.

As we pivot to start working with the incoming administration, ANA has hit the ground running, providing substantive recommendations to transition leaders, and applauding the appointment of a registered nurse to President-elect Biden’s COVID-19 Task Force. We have communicated the many ways in which ANA and nurses can be a resource to the transition and the upcoming administration. We continue to solidify relationships to ensure that ANA will maintain a strong voice in the White House and key agencies in the months ahead.

Like the rest of the Policy and Government Affairs team, the ANA Political Action Committee (ANA-PAC) experienced a very successful year in 2020 despite the multitude of challenges it faced at the start of the pandemic. For starters, the PAC continued its winning streak with a 95 percent win rate in the 2020 general election for the nearly 100 candidates the PAC supported based on their pro-nursing agendas. Members of ANA drove their support unlike in years passed to the tune of over 5,600 contributors to the PAC which was an increase of 34 percent over 2019 and counting! And it doesn’t stop there: the financial strength of the PAC continues to improve as receipts are up 3 percent over last year and this number only continues to grow as we head toward the year end. Policy and GOVA will be spending the early part of 2021 strategizing our support for our existing nursing champions and starting new outreach efforts to those new freshman members of Congress. Stay tuned for updates in the next ANA-PAC quarterly newsletter.

ANA advocacy on federal regulatory policy has also strengthened nurses and demonstrated the power of nurses’ voices. With the COVID-19 PHE extended until March 2021, Medicare payment flexibilities gained in 2020 will continue. A number of these provisions expand access to APRNs for non-COVID-19 care as well as COVID-19 care, which has been a boon to patients and their providers throughout the pandemic, especially in rural areas.

The readiness of the Centers for Medicare and Medicaid Services (CMS) to remove regulatory barriers to practice has come as a result of direct advocacy over the years by ANA and partner organizations. The voices of frontline nurse providers were also heard, as CMS gathered first-hand accounts and created space to share this information on regular conference calls with nurses about the impacts of COVID-19 on their practice.

The pandemic has demonstrated the value of APRNs across the health care system, and CMS’ actions tell us that Medicare leaders are hearing us. The future is indeed bright, as CMS continues to review unnecessary barriers and craft regulatory relief. ANA policy leaders are right there, urging specific changes, and making a powerful case for making permanent changes to expand access to APRNs. We saw some success in the physician payment rule for 2021, which removed federal restrictions on APRN supervision of diagnostic tests.

CMS was not the only agency hearing nurses’ voices as important decisions were made. Early and often, ANA repeatedly called for steps to improve protections for frontline providers, including a return as soon as possible to pre-pandemic standards for PPE.

We made our case to the Occupational Safety and Health Administration, the Office of Minority Health at HHS, the Department of Veterans Affairs, Federal Emergency Management Agency, Government Accountability Office, and the White House Economic Advisors. ANA has become the “go to” organization for agency staff when they hear about events happening on the ground to work together to improve conditions for nurses. 

The pandemic made ANA’s presence even more valuable with the American Medical Association’s (AMA) RUC and CPT committees, which are the driving force for health care reimbursement. ANA CPT advisors were at the table when the CPT codes for both the Pfizer and Moderna vaccines were developed. In a separate process, ANA advisors were consulted to account for increased practice expenses incurred during the pandemic. Throughout, ANA engaged feedback and comment from the nursing community. All of these accomplishments could not be done without the loud impassioned voice of our ANA members and RNAction advocates. This united voice sent nearly 460,000 letters to Congress, responded to public comments and engaged in several surveys where the results were presented to Congressional offices across Capitol Hill. All of the input from nurses, our nation’s most trusted profession for 18 straight years, directly impacted legislation and policy throughout the year. We have you to thank for that – your efforts on the frontlines, your expertise and your advocacy do not go unnoticed. With over 200,000 RNAction advocates, we are poised to improve the profession of nursing and conditions for your patients again in 2021.

ANA Advocacy Team Prepares for a New Administration and a New Congress

  

The ballots have been cast and we are now waiting for the electoral college to come together to cast their votes for the next President of the United States. The projected winner is Joe Biden and his transition team is already working to prepare for the start of his presidency, and Congress is currently electing their leadership for the 117th session.

Just as the President-Elect and Congress are preparing for 2021 – so is ANA’s Policy and Government Affairs team. ANA seeks to maintain a position as a leader on nursing issues with both the new Administration and Congress – and advocacy has already started. Two letters have been sent to the Biden transition team – one capturing ANA’s priorities and the other related to placing a registered nurse on the Biden COVID-19 Task Force.

We want you to know that the Policy and Government Affairs team has developed a comprehensive “100 Day Advocacy Plan” which will encompass all levels of advocacy – Administration, legislative, regulatory, grassroots and political. The plan is a coordinated approach to ensure that ANA’s policies and priorities are shared at all levels of the federal government.

We remain committed to finding opportunities for nurses to be at the table; –We will resume our outreach with career policy makers at federal agencies and seek to establish meaningful relationships with the newly appointed leaders to support a swift and seamless transition between administrations.

Last year ANA achieved several legislative victories and thanks to many of you we increased our advocacy network by over 160%. The Policy and Government Affairs team will continue this level of excellence in the next Congress, working closely with returning members as well as establishing relationships with newly elected freshman. Our team will continue to seek opportunities for nurses to testify before Congress and make your voices heard. Please know, that early on we will be asking our nurse advocates to reach out to their newly elected Congressional Members not only to congratulate them, but to offer to be a resource on health care issues.

Our Administration has changed – but our work continues. Much more needs to be done to ensure that our frontline providers have access to PPE and other resources as they continue to combat COVID-19. ANA is working with our colleagues to ensure APRNs can work to their full scope. As telehealth continues to grow as a health care delivery model – ANA will be there to support those efforts. That’s just a few of the issues we are working on!

ANA is prepared with a solid plan to support the interests of the 4.2 million registered nurses. However, we can’t do this alone. We need nurses and nurse advocates to actively engage in the process. Please sign up for alerts at RNAction.org, visit our advocacy page, and read our Capitol Beat blog for all the latest activities of ANA’s Policy and GOVA Department.