Over the past 30 days, two pieces of federal legislation were introduced that address areas of frequent discussion by nurses, namely the national image of nurses and the inadequacy of our healthcare system. Texas Congresswoman and registered nurse, Eddie Bernice Johnson, introduced the National Nurse Act of 2019 (H.R. 1597/ S. 696) earlier this month, to designate the U.S. Public Health Service, Chief Nurse Officer as also the “National Nurse for Public Health.” Separately, Washington State Representative, Pramila Jayapal, introduced the Medicare for All Act of 2019 (H.R. 1384), an intervention to address the millions of under-insured and uninsured Americans whose lack of access to affordable and quality healthcare can result in bankruptcy, disability, and death.
Representative Johnson’s proposed designation of the Chief Nurse Officer as also the “National Nurse for Public Health”, is similar to the President of the United States also being known as the Command in Chief. The purpose of the designation is to elevate a publicly recognizable advocate for preventative health and nurse-led community health initiatives, while also promoting the profession of nursing (The National Nursing Network Organization, 2019).
The Act has undergone a number of iterations after initial congressional introduction in the early 2000s. Notably, the American Public Health Association- Nursing Section, declined to contribute to the bill and has not endorsed the Act, while the American Nurses Association remains neutral in their support, leaving state nurses associations free to endorse, or not. The National Nurse Act of 2019 currently has 69 bipartisan co-sponsors in the House, and more than 50 nursing and labor association endorsements (Johnson, 2019). You can find more information about the bill at The National Nursing Network Organization.
Representative Jayapal’s Medicare for All Act, proposes using existing networks of hospitals and doctors to provide healthcare to Americans without premiums, copays, or deductibles under a single payer, government insurance program (Congressional Record–House, 2019). The bill includes vision, dental, hearing, mental health and substance abuse services, long-term care, maternal health, and primary care. National Nurses United (NNU), the California-based union, endorsed the bill and has undertaken a grassroots effort to promote its adoption using nursing and progressive activists from around the country to put pressure on legislators to support the bill (Castillo, 2019). Polling by the Pew Research Center (2018), indicates that 60% of Americans “say ensuring health care coverage is a government responsibility,” with disagreements, unsurprisingly, falling along party lines.
As nurses, we know that we aren’t dealing with a case of “if it ain’t broke, don’t fix it”; the healthcare system is broken. According to the the United States Census Bureau (2018), 28.5 million Americans, or 8.8%, did not have health insurance. Unsurprisingly, the states that have not expanded Medicaid coverage under the Affordable Care Act have higher uninsured rates (i.e. 6.5% uninsured in Medicaid expansion states, compared with 12.2% in non-expansion states), according to the same source (2018). What continues to be troublesome is being under-insured, meaning you have insurance, but the deductibles may be too high to afford treatment or medication. Rising prescription drug prices and increased insurance costs have made accessing routine healthcare difficult for millions of Americans who do have health insurance. High insulin prices have even resulted in deaths, as diabetics ration their insulin due to increased costs (Bauman & Chakrabarti, 2019). This bill is one to watch as it has a direct impact on our most vulnerable patients, as well as our own families.
Disclosure: The author of this piece is on the advocacy board for the National Nurse Act of 2019 and is vested in its mission to support health promotion and disease prevention by reinforcing and elevating nurse’s leadership roles at the national, state, and community levels.
Vanessa Shields-Haas is a radical nurse and co-founder of www.radicalnurses.com. She advocates for harm reduction approaches to care and reproductive freedom for women in the deep South.
Bauman, A., Chakrabarti, M. (2019 March 6). Activists demand plan from drugmaker Sanofi to lower ‘pressing’ Insulin prices. WBUR- NPR, Boston. Retrieved from https://www.wbur.org/onpoint/2019/03/06/sanofi-insulin-diabetes-prescription-drugs
Berchick, E. R., Hood, E., Barnett, J. C. (2018). Current population reports, P60-2664. Health insurance coverage in the United States: 2017. Washington, DC: U.S. Government Printing Office. Retrieved from https://www.census.gov/content/dam/Census/library/publications/2018/demo/p60-264.pdf
Castillo, B. (2019 March 3). It’s time for legislators to prove democracy exists by passing Medicare for All. The Hill. Retrieved from https://thehill.com/opinion/healthcare/432392-its-time-for-legislators-to-prove-democracy-exists-by-passing-medicare-for
Congressional Record, Pramila Jayapal. (2019 March 13). Medicare for All Act. Retrieved from https://www.congress.gov/116/crec/2019/03/13/CREC-2019-03-13-pt1-PgH2709.pdf
Johnson, E. B. (2019, March 7). Congresswoman Johnson introduces National Nurse Act of 2019 [Press release]. Retrieved from https://ebjohnson.house.gov/media-center/press-releases/congresswoman-johnson-introduces-national-nurse-act-of-2019
Kiley, J. (2018 October 3). Most continue to say ensuring health care coverage is government’s responsibility. Pew Research Center. Retrieved from http://www.pewresearch.org/fact-tank/2018/10/03/most-continue-to-say-ensuring-health-care-coverage-is-governments-responsibility/
Photo of Congress. (2011). Public Domain. Retrieved from https://commons.wikimedia.org
The National Nursing Network Organization. (2019). H.R. 1597 and S. 696 the national nurse act of 2019. Retrieved from http://nationalnurse.org/