Title VIII – Capitol Beat

From the Bedside to the Capitol: ANA Hill Day 2026

Nurses from across the country will gather in Washington, D.C. for the American Nurses Association’s (ANA) 2026 Capitol Hill Day this month to advocate for federal nursing priorities. After a policy briefing, they will meet with lawmakers to highlight the below issues affecting nurses and patient care.

Fight for Fair Graduate Student Aid

In May, the U.S. Department of Education finalized a rule classifying post-baccalaureate nursing programs as “graduate programs”, reducing borrowing limits for nursing students to $20,500 annually and $100,000 lifetime, compared with $50,000 and $250,000 for “professional degree” students. This is especially harmful for nursing students in accelerated programs who may hit borrowing caps before finishing their degrees.

Nurse advocates will urge lawmakers to support the Nursing Is a Professional Degree Act (H.R. 8691/S. 4568) to ensure that nursing students qualify for the higher graduate loan limits and support a Congressional Review Act resolution (H. J. Res. 189/S.J.Res.196) to repeal the rule. The adoption of these policies would ensure equitable access to federal financial aid and strengthen our nursing workforce.

Protect Nurses from Workplace Violence

Workplace violence is a major threat, with 75% of the nearly 25,000 workplace assaults reported each year occurring in health care and social service settings. One in four nurses reports being assaulted in their workplace. In fact, nurses are more likely to be victims of workplace violence than police officers or prison guards. The cost to the U.S. healthcare system exceeds $151 billion per year, not including the hidden costs of trauma, burnout, and attrition that drive nurses out of the profession.

The Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 2531/S. 1232) would require the Occupational Safety and Health Administration (OSHA) to issue standards that healthcare employers would use to develop workplace violence prevention plans to protect their clinicians and patients. It would ensure that nurses and other direct-care workers help develop and implement those plans. The bill also protects nurses who report workplace violence. Nurse advocates will urge lawmakers to co-sponsor this critical legislation and take a concrete step toward ensuring nurses can care for their patients without fearing for their own safety.

Break Down Barriers Facing APRNs

Advanced practice registered nurses (APRNs) now provide more than half of all primary care for Medicare patients, and decades of research demonstrate that they provide safe, high-quality care. Yet, federal law still requires unnecessary physician oversight and limits APRN practice.

The bipartisan Improving Care and Access to Nurses (ICAN) Act (H.R. 1317/S. 575) would remove outdated Medicare and Medicaid barriers that prevent APRNs from practicing to the full extent of their education and training. The measure notably does not supersede any state laws or alter APRNs’ scope of practice and has support from over 260 organizations.

ANA advocates will urge lawmakers to support the ICAN Act to expand access to quality care for patients — particularly those in rural and underserved communities — while empowering APRNs who are already proving every day that they are more than capable of meeting that need.

Invest in Nursing Education and Training

The Title VIII Nursing Workforce Development Programs are the only dedicated federal investment in nursing education, practice, and retention — yet they receive just $305.472 million compared to the $17.8 billion in mandatory federal spending directed toward graduate medical education. Last reauthorized in 2020, Title VIII programs supported more than 24,000 nurses, nursing students, and grantees in FY 2025 alone, helping to chip away at our nation’s nursing workforce shortage.

Nurse advocates will ask their lawmakers to fund the Title VIII programs at a minimum of $610 million in FY 2027, and to pass the Title VIII Nursing Workforce Reauthorization Act (H.R. 3593/S. 1874) to reauthorize the programs through FY 2030 — ensuring the pipeline of qualified nurses remains strong and that patients across the country continue to have access to high-quality care.

Call to Action

While registration for ANA’s 2026 Hill Day has closed, you can still make your voice heard. ANA is organizing a virtual day of action to coincide with Hill Day on 6/25 to amplify the message being shared by nurses on Capitol Hill.

Mark your calendars and be on the lookout for an RN Action Alert on June 25!

Rebuilding America’s Nursing Workforce—Title VIII Programs

America continues to face a geographic nursing workforce shortage, particularly in rural and medically underserved communities.

Inadequate staffing tends to have an adverse, ripple effect on the nursing workforce and the ability of healthcare facilities to provide timely, high-quality healthcare services. One solution to this staffing crisis is for policymakers to continue to invest in nursing education by supporting the Title VIII Nursing Workforce Development Programs.

There will be about 194,500 openings for registered nurses (RNs) annually through 2033 due to nurse retirements and other workforce exits.
U.S. Bureau of Labor Statistics

What are the Title VIII Nursing Workforce Development Programs?

The Title VIII Nursing Workforce Development Programs represent the only dedicated federal programs addressing all aspects of nursing workforce development, including education, practice, and retention. These programs are administered by the Health Resources and Services Administration within the U.S. Department of Health and Human Services. Here is an overview of the Title VIII Programs:

ADVANCED NURSING EDUCATION PROGRAM – The Advanced Nursing Education Program helps support advanced practice registered nursing (APRN) students so they may practice in rural and underserved settings. This program also focuses on increasing nurses in primary care through traineeships opportunities.

NURSING WORKFORCE DIVERSITY PROGRAM – The Nursing Workforce Diversity Program increases nursing education opportunities for students underrepresented in the profession by supporting career advancement for nurses with diplomas to become baccalaureate prepared registered nurses (RNs) or graduate-prepared advanced practice registered nurses (APRNs).

NURSE EDUCATION, PRACTICE, QUALITY AND RETENTION PROGRAM – The Nursing Education, Practice, Quality and Retention Program focuses on national nursing needs and strengthens nursing workforce capacity.

NURSE FACULTY LOAN PROGRAM – The Nurse Faculty Loan Program works to increase the number of qualified nurse educators by awarding funds to institutions that provide student loans to graduate students willing to serve as faculty upon graduation.

NURSE CORPS SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS – The Nurse Corps Scholarship Program awards scholarships to individuals who are enrolled or accepted in a school of nursing, in exchange for service of at least two years in a Critical Shortage Facility (CSF) after graduation. The Nurse Corps Loan Repayment Program assists in the recruitment and retention of RNs and APRNs to work in CSFs or as faculty in nursing schools by providing these nurses with loan repayment benefits.

Importance of Reauthorizing the Title VIII Nursing Programs

The Title VIII Programs were last reauthorized in 2020 as part of the Coronavirus, Aid, Relief, and Economic Security (CARES) Act for a period of five years. Anticipating the need to reauthorize these critical programs, the American Nurses Association (ANA) and its allies in the nursing community worked with a bipartisan group of congressional champions to introduce the Title VIII Nursing Workforce Reauthorization Act (H.R. 3593 / S. 1874). Both bills have garnered bipartisan support on Capitol Hill.

In fact, the House Energy and Commerce Committee held a hearing earlier this year to examine H.R. 3593. Unfortunately, the federal government shutdown slowed down momentum for moving this bill and authorization for the programs expired on October 1^st. Without the passage of this bill, the Title VIII Programs are at risk for losing congressional funding and being eliminated altogether. Our team continues to advocate for reauthorization during ongoing conversations with key Leadership and committee staff on both sides of the aisle.

Congressional Funding is Critical to Expand Nursing Workforce

Despite making up the largest sector of the healthcare workforce at over 5 million nurses, congressional support for nursing workforce development currently stands at $305.472 million in discretionary spending under the current continuing resolution which is in effect until January 30, 2026. This amount pales in comparison to the $17.8 billion in mandatory funding that Congress provides to graduate medical education. Unfortunately, the Senate Appropriations Committee approved a healthcare spending bill that would provide $303.472 million for the Title VIII Programs in Fiscal Year 2026. The measure proposes a $2 million haircut to the Nursing Workforce Diversity Program.

Even worse, the House Appropriations Committee took a machete to the Title VIII Programs by proposing to cut these programs by $47 million. Specifically, the bill would eliminate funding for the Nursing Workforce Diversity Program and the Nurse Faculty Loan Program. The adoption of the House bill would make it harder for our nation to attract talented nurse faculty to educate the next generation of nurses. It would also make it more difficult for our nation to attract a nursing workforce that meets the needs of all Americans. Consequently, ANA and its nursing allies are now requesting that Congress provide at least $303.472 million for the Title VIII Programs in FY 2026 by adopting the Senate’s healthcare spending bill.

How You Can Help Protect Nursing Education

There are plenty of ways that nursing advocates can help ANA protect the Title VIII Programs and nursing education. The easiest way is to reach out to your members of Congress to ask for their support for reauthorization and funding for these vital programs by visiting RNAction.org. Nursing advocates can also schedule meetings with their lawmakers and their staff in their district offices during constituent work periods. Visit ANA’s In-District webpage that share tips for scheduling and executing these meetings. Finally, ANA members can join the Nurses Action Society if they would like to leverage their existing relationships with federal lawmakers or would like to develop relationships with lawmakers on Capitol Hill.

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.