Top concerns include improved work environments, access to nursing care, and payment parity.

This year promises to be quite active for federal advocacy by the American Nurses Association, which has passionately advanced the interests of nurses to help shape legislative and regulatory policy for more than 125 years. With the new Congress underway, President Trump has returned for his second term, and Republicans control both the House and the Senate by very narrow margins. As Congress settles in, the association is advocating across a broad range of priority issues for nurses and the nursing profession.

“As the organization that represents the interests of all the nation’s 5 million RNs, our advocacy efforts ensure that nurses’ vital role, voice, and value in healthcare and society are heard and recognized,” said American Nurses Association President Jennifer Mensik Kennedy, PhD, MBA, RN, NEA-BC, FAAN. “Our priorities remain unchanged in 2025, and we look forward to productive discussions with Congress and the Trump administration.” The association’s top priorities include promoting and protecting the nursing workforce, removing practice barriers for advanced practice RNs (APRNs), and achieving payment parity for nurses. The first step this year will be to have our previous bills reintroduced—a tall task as the association advocated for more bills last Congress than we have record of doing before.

Here is a look at progress made during the last Congress and priorities for 2025.

Extending tax cuts

President Trump and Senate and House Republicans have stated their goal of extending the 2017 Tax Cuts and Jobs Act which expires at the end of this year. We want to see the PRECEPT Nurses Act and the Nurse Corps Tax Parity Act included in this extension.

The former establishes a tax credit for nurses who serve as nurse preceptors in health professional shortage areas. Specifically, the bill establishes a $2,000 tax credit for nurses or healthcare providers who serve as nurse preceptors for at least 200 hours.

The Nurse Corps Tax Parity Act ensures tax-status parity between the National Health Service Corps (NHSC) and Nurse Corps programs by amending the Internal Revenue Code to create parity in tax treatment for these two scholarship and loan repayment systems. Currently, scholarships and loans are not taxed for those participating in NHSC while those in the Nurse Corps are.

Enhancing nursing education

The longstanding faculty shortage remains a significant barrier to training and educating more people as nurses. This crucial gap exists largely due to low starting salaries for faculty positions and high student loan amounts owed by recent graduates. The association proudly participated in creating the Nurse Faculty Shortage Reduction Act that was introduced for the first time last Congress in both the House and Senate. This bi-partisan, bi-cameral bill would create a 5-year pilot project that would allow schools of nursing to apply for grants from the Health Resources and Services Administration to supplement the difference between what faculty nurses are paid versus what equally trained nurses in critical care earn.

The association also supports the Stop Nurse Shortages Act introduced by U.S. Representatives Haley Stevens (D-MI) and Dave Joyce (R-OH), co-chair of the Congressional Nursing Caucus. This bill would establish a grant program to help nursing schools create, expand, or support accelerated nursing degree programs that train individuals with undergraduate degrees in other fields to become nurses at an accelerated pace.

We support another measure, the Educating Future Nurses Act, which would establish a permanent funding stream in Medicare for hospitals to partner with schools of nursing, community-based care settings, and other hospitals to increase clinical education for APRN students. The idea for this bill came from a similar 5-year pilot program included in the Affordable Care Act.

2025 also marks the time to re-authorize Title VIII Nursing Workforce Development Programs that provide loan repayment assistance, scholarship options for nurses, grants for advanced education nursing programs, nursing workforce diversity grants, and loans for nurse faculty development. Congress typically extends healthcare programs in 5-year increments albeit rarely on time. Before the last reauthorization in 2020, the Nursing Workforce Development Programs went 5 years without authorization, but continued to function. Together with our nursing community colleagues and Congress, we are working to see the programs reauthorized without major changes to how they operate.

Improving nurse staffing

With Republicans in control of the House, Senate, and White House, we don’t anticipate major traction on nurse staffing issues because Republicans have been staunchly against regulations dealing with labor and workforce issues. However, inroads might be possible on legislating or regulating mandatory overtime for nurses because of burnout and patient safety, but not hard nurse-to-patient ratios. The association will continue to advocate for all available options to relieve workloads and unsafe working environments for nurses.

In addition, the association will again lobby Congress to pass the Nurse Overtime and Patient Safety Act. This bill would prohibit mandatory overtime for nurses and provide whistleblower protections for nurses who advocate for the safety of their patients.

On the regulatory front, we will continue to urge the Centers for Medicare and Medicaid Services (CMS) to use its existing regulatory oversight authority and mechanisms to hold healthcare facilities accountable for safe work environments that allow nurses to provide the level and extent of care needed for their patients. The association stands ready to work closely with CMS to identify and implement appropriate approaches to nurse staffing standards across all care settings.

At the same time, the association will continue to defend the April 2024 final rule that established minimum nurse staffing standards in long-term care facilities nationwide. Full implementation of the rule remains under threat from congressional action and ongoing litigation seeking to completely rescind the rule. Survival of the rule’s 24/7 RN requirement for these facilities—a policy the association has long advocated for—remains a top priority.

Ending workplace violence

For many years, the association has advocated for the Occupational Safety and Health Administration (OSHA) to create a workplace violence (WPV) prevention standard, which was among our first asks of former President Biden’s transition team in 2020. OSHA since 1996 has released non-mandatory guidance for employers to build evidence-based prevention programs. The agency completed the first step in its rulemaking process in March 2023, but we’re still awaiting the next step—release of a proposed standard for public review and comment. As of Spring 2024, OSHA confirmed that this standard has dropped to fourth in line behind standards involving heat, first responders, and infectious diseases.

To urge the agency to act, the association led a sign-on letter to OSHA from nearly 60 nursing organizations. At our urging, former acting secretary of labor Julie Su was questioned about the lack of progress on this standard during a Congressional hearing on May 1, 2024.

To counter the lack of administrative action, the association is supporting the Workplace Violence Prevention for Health Care and Social Service Workers Act. This bill would require OSHA to develop and enforce specific standards for healthcare and social service employers that would hold them accountable for protecting their employees from WPV. This legislation passed in the House during the 117th and 116th Congresses with significant bipartisan support. The association is urging the Trump administration to aggressively advance a standard to protect healthcare workers and patients.

In addition to its federal regulatory work, the association kept up the pressure and conversation on this issue at the state level through collaboration with the National Lieutenant Governors Association (NLGA). This bipartisan organization promotes interstate cooperation and knowledge sharing among all lieutenant governors.

At the April 2024 NLGA meeting, attendees unanimously approved our consensus resolution on WPV prevention in healthcare. The resolution acknowledges the severe nature of WPV in healthcare and urges members to recognize and support programs aimed at mitigating this pervasive issue.

The consensus resolution demonstrates the association’s commitment to addressing WPV through state and national advocacy and by supporting the implementation of comprehensive prevention strategies. This continued effort remains vital to ensure the safety and well-being of nurses and other healthcare professionals.

Improving patient access

APRNs are highly qualified clinicians in their specialty fields. Yet many outdated Medicare regulations restrict APRNs from caring for their patients without physician supervision or being paid for certain services. Such restrictions limit access to care and beneficiaries’ choice of qualified provider. The association contends that APRNs must be allowed full practice authority in federal programs aligned with their state licensure.

The association continues to press CMS to release the final Provider Nondiscrimination Rule, which would prevent discrimination in payment, contracting, and unnecessary practice restrictions, and allow APRNs to practice to the top of their license in federal health programs.

More than 83% of nurse practitioners treat Medicare patients and the profession is now the most frequent biller of Medicare, outpacing physicians. A compelling need exists to reform Medicare laws to eliminate outdated, arbitrary regulatory barriers to better reflect the critical role APRNs play to ensure patients have access to needed, quality care. This is why the association is once again advocating for passage of the Improving Care and Access to Nurses Act. The bill would permanently remove barriers to care and increase access to high-quality services provided by APRNs under Medicare.

Shaping payment strategies

The association is encouraging the Trump administration as it did the Biden administration to take regulatory and administrative steps to account for nursing care in payment methods. Innovative payment approaches that align provider incentives with the extent and quality of care nurses provide are needed to achieve the best outcomes for patients. APRNs and RNs in virtually every setting are indispensable to providing the care that patients need. However, federal reimbursement and quality reward systems don’t incentivize care delivery that values nurses and their well-being on the job. Recognition through appropriate payment for nursing services is essential to ensuring a resilient nursing workforce ready and able to meet future needs. We are engaging federal agencies to achieve payment innovations that align reimbursement and quality rewards with high-value nursing care.

Protecting healthcare for all

Since the new administration took office, we’ve seen a whirlwind of executive orders and actions reshaping federal operations, policies, and the workforce. We anticipate many of these changes will be significant, impacting many individuals. As the American Nurses Association, we stand in support of policies which guarantee that all Americans are being taken care of, and we continue to lean into our values to safeguard nursing workforce policies that create opportunities for all Americans, including drawing discouraged workers into the labor force and supporting equitable healthcare access and outcomes for all.

As the year unfolds, we will work strenuously to shape legislative and regulatory policy—through coalition building, advocacy, and political action, seeking to enhance the profession and the overall quality of care nurses can deliver. All nurses can bolster these advocacy efforts by engaging in grassroots advocacy opportunities. Participation by individual nurses, whether through constituent/state nurses associations (C/SNAs) or directly with the American Nurses Association at the federal level, adds up and can lead to significant legislative and policy wins. The association is proud to work alongside its members, C/SNAs, and nurses across the country to ensure that decision-makers in Washington, D.C. hear what nurses need most.

— Sam Hewitt is director of congressional and political advocacy and Zina Gontscharow is director of policy and regulatory advocacy at the American Nurses Association.

American Nurse Journal. 2025; 20(3). Doi: 10.51256/ANJ032532