The 110th Congress began in January 2007 with high hopes that the new Democratic majorities in the House and Senate would make significant strides in healthcare legislation. As the session came to a close last month, nurses could take pride in a few victories, and look forward to a few more battles in the coming years. Following is a quick summary of where we stand.
Insurance reform
Nurses were instrumental in supporting the Genetic Nondiscrimination Act (P.L. 110-233). This law makes it illegal for employers to base hiring, firing, and promotion decisions on genetic test results. In addition, health insurers are forbidden from basing coverage or premiums on genetic test results.
The 110th Congress also passed two important laws changing longstanding insurance discrimination against those facing mental illness. One victory was included in the Medicare Improvements for Patients and Providers Act (P.L. 110-175). This law eliminated discriminatory co-payments for Medicare outpatient psychiatric services. Cost sharing for outpatient mental health services will be phased down from 50% to 20% by 2014.
Another victory came when the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (P.L. 110-343) was signed into law. This law bans employers and insurers from imposing stricter limits on coverage and co-payments for mental health and substance-use conditions than those set for physical problems. ANA thanks all of the nurses across the nation who contacted Congress in support of these bills.
Respirator fit testing reinstated
Nurse activists across the country defeated an amendment by Representative Roger Wicker (R-MS) that would have banned the Occupational Safety and Health Administration (OSHA) from enforcing the annual fit-test requirement for respirators used in healthcare settings. ANA strenuously opposed the Wicker rider because it seriously undermined the effectiveness of these respirators and needlessly placed nurses at increased risk for contracting and transmitting infectious diseases.
Rep. Wicker offered his amendment during consideration of the FY 2008 health funding bill. Nurses contacted Congress in opposition to the amendment, which was ultimately rejected. The OSHA fit-testing requirement has now been reinstated.
Nursing shortage
Working with schools, students, and nurses, ANA was able to beat back President Bush’s proposals to significantly cut funding for the Title VIII Nursing Workforce Development Programs. In fact, we secured a $6 million increase in funding for fiscal year 2008. Final action on 2009 funding has been delayed until March 2009.
ANA also supported a successful effort to include nursing programs in the Higher Education Opportunity Act (P.L. 110-315). This law created a capitation program to support nursing schools, a $10,000 loan repayment program for new graduates, support for nursing faculty, and studies on nursing school capacity constraints.
Nurse staffing and mandatory overtime
ANA is also committed to improving the healthcare workplace to retain nurses in patient care. To that end, ANA is promoting the RN Safe Staffing Act and the Safe Nursing and Patient Care Act. The RN Safe Staffing Act would require hospitals to enact valid, reliable unit-by-unit nurse staffing plans. These plans would be developed in coordination with direct-care RNs and be based on each unit’s unique characteristics and needs. By the end of the 110th Congress, this bipartisan legislation received the support of 38 Democrats and 9 Republicans in the House of Representatives. You can learn more about ANA’s efforts at www.safestaffingsaveslives.org.
ANA also continues to work to enact legislation outlawing the use of mandatory overtime. The Safe Nursing and Patient Care Act would make it illegal for a healthcare facility to retaliate in any way against a nurse who refuses a request for unscheduled overtime. By the end of the 110th Congress, this legislation had received the support of more than 100 members of the House and Senate.
Medicare coverage of Advanced Practice RNs
ANA fought successfully to include APRNs as qualified electronic perscribers in a Medicare demonstration. Participating APRNs will receive an additional 2% payment increase in fiscal years 2009 and 2010. We were also successful in securing the House introduction of the Home Health Care Planning and Improvement Act, which would allow APRNs to certify and sign home health plans of care for Medicare patients.
Erin McKeon is Associate Director in ANA’s Government Affairs Department.
