The American Nurses Association (ANA) frames its federal health care legislative work around a small set of recurring priority areas, and each area comes with practical and ethical considerations for policymakers, nurses, and the public.

The Four Major Priority Areas

Across ANA national and state-level agendas, four core legislative directions consistently appear:

  • Health system transformation and access to care
  • Nursing workforce development and education
  • Workplace health and safety (including violence prevention)
  • Expanding primary, community, and home-based care (scope of practice and models of care)

These themes are sometimes worded slightly differently by ANA or state ANA affiliates, but the underlying principles are stable.

1. Health System Transformation & Access

ANA emphasizes “renovating” the U.S. health system so everyone can access a standard package of essential services.

Key considerations include:

  • Ensuring universal access
    • Coverage for all residents; no denial for pre‑existing conditions; keeping young adults on parents’ plans to age 26; Medicaid expansion as a safety net.
* Policy tension: universal benefits vs. cost containment and political resistance to expanded public coverage.
  • Designing benefits and payment models
    • Removing annual or lifetime caps, using income‑based subsidies, and promoting payment models that reward prevention and care coordination rather than volume of services.
* Consideration: who pays for expanded benefits, and how to prevent underfunding of safety-net programs.

These agendas push lawmakers to balance equity (access for vulnerable groups) with system sustainability and federal–state budget realities.

2. Nursing Workforce & Education

Nursing workforce development is a central legislative plank, anchored in Title VIII nursing workforce programs and related grant/loan initiatives.

Key considerations include:

  • Funding and program scope
    • Grants and loan repayment to increase the primary care and nursing workforce, expand nurse faculty, and improve workforce diversity.
* Need to regularly reauthorize and adequately fund Title VIII programs, which support advanced education, workforce diversity, and geriatric education.
  • Long‑term capacity and equity
    • Avoiding nursing shortages by investing in education pipelines, especially in rural and underserved communities.
* Ensuring diversity to better reflect patient populations and address disparities in care.

Policy debates often revolve around how much federal money to commit, which specialties to prioritize, and how to measure impact on patient outcomes.

3. Workplace Health, Safety, and Violence Prevention

ANA treats workplace safety—notably workplace violence against nurses—as a major federal legislative concern.

Key considerations include:

  • Regulatory protections
    • Support for legislation requiring OSHA to develop and enforce workplace violence prevention standards for health and social service workers.
* Balancing compliance burdens on facilities with the urgency of protecting staff from abuse, assault, and psychological harm.
  • Broader safety issues
    • Adequate personal protective equipment (PPE), mental health support, hazard pay, and infrastructure to respond to emergencies like COVID‑19.
* Consideration of how safety policies intersect with staffing levels, burnout, and retention.

These agendas raise questions about employer responsibilities, federal versus state regulation, and costs associated with robust safety programs.

4. Primary, Community, and Home-Based Care

ANA strongly supports expanding access to primary and community care, including home health, and protecting RN/APRN scope of practice.

Key considerations include:

  • Scope of practice and autonomy
    • Removing barriers that prevent registered nurses and APRNs from practicing to the full extent of their education and training.
* Examples include authorizing APRNs to order home health services for Medicare patients (especially in rural/underserved areas) and broadening prescriptive authority in areas such as medication-assisted treatment for opioid use disorder.
  • Access and equity in underserved areas
    • Funding mobile health units, home visiting programs, and telehealth services to reach rural and medically underserved communities.
* Weighing concerns from some physician groups about role overlap against evidence that APRN-led care can be safe, high-quality, and cost-effective.

Here, legislators must consider workforce capacity, patient safety, cost- effectiveness, and how best to use nurses’ expertise to close care gaps.

Related Cross-Cutting Issues ANA Ties In

While not always framed as separate “major agendas,” ANA frequently links several other issues to the four core areas:

  • Opioid epidemic response
    • Support for comprehensive, multi-level approaches and sustained prescriptive authorities for advanced practice nurses in medication-assisted treatment.
  • Gun violence prevention and public health infrastructure
    • Advocacy for gun violence prevention and stronger public health systems as essential to community health and nurse safety.
  • Emergency and pandemic preparedness
    • Policies on PPE, vaccines, and infrastructure to protect both patients and the nursing workforce in crises.

These are integrated into broader ANA arguments that a transformed health system must protect both patients and providers while advancing equity and access.

Information gathered from public forums or data available on the internet and portrayed here.