With Patient and Persistent Advocacy, Nurses Help Pass Critical Healthcare Legislation

One of the most practical safeguards (https://www.congress.gov/help/learn-about-the-legislative-process/how-our-laws-are-made) of the American democratic way of life is this legislative process with its emphasis on the protection of the minority, allowing ample opportunity to all sides to be heard and make their views known. The fact that a proposal cannot become a law without consideration and approval by both houses of Congress is an outstanding virtue of our bicameral legislative system. The open and full discussion provided under the Constitution often results in the notable improvement of a bill by amendment before it becomes law or in the eventual defeat of an inadvisable proposal.

That victory represents years of tireless advocacy. Thousands of bills are introduced through the U.S. Congress annually, but only 213 became law during 2022’s 117th congressional session. Some ideas are introduced to simply begin a formal conversation on the topic. Others, like many on the ONS Health Policy Agenda, including the Lymphedema Treatment Act, have been promoted for more than a decade.

Nurses’ Power in Policy

When nurses speak, decision-makers listen. The Lymphedema Treatment Act is proof in point: During the September 2022 ONS Capitol Hill Days, ONS member advocates lobbied for the bill directly with their congressional representatives. By sharing their patient stories, ONS members ensured lawmakers understood the critical need to pass the legislation.  

Another part of nurses’ power lies in their patience and persistence. Even when a bill doesn’t pass during that year’s congressional session, nurse advocates are laying essential groundwork for future victories. Following in the footsteps of Florence Nightingale, who said (https://blog.nursing.com/florence-nightingale-quotes), “Rather, 10 times, die in the surf, heralding the way to a new world than stand idly on the shore,” the entire nursing advocacy community remains dynamic and charges into the fray with the understanding that meaningful advancements will happen.

Help Your Peers Herald the Way

Triumphs like the Lymphedema Treatment Act fuel the flames of nursing advocacy. Increasing access to lymphedema supplies dissolves disparities for many patients, but barriers remain in all aspects of cancer care. Although they didn’t pass in the 2022 117th congressional session, oncology nurses influenced many recent pieces of legislation, including:

• TIKES Act (H.R. 1397) (https://www.congress.gov/bill/117th-congress/house-bill/1397): Promotes and evaluates the use of telehealth under Medicaid and the Children's Health Insurance Program
• Medical Nutrition Therapy Act (H.R. 3108/S. 1536) (https://www.congress.gov/bill/117th-congress/senate-bill/1536/text): Expands the list of Medicare-covered diseases to include cancer and allows for a nurse practitioner to guide the process
• PREVENT HPV Cancers Act (H.R. 1550) (https://www.congress.gov/bill/117th-congress/house-bill/1550): Requires educational materials to include information about both cervical cancer and other human papillomavirus (HPV)-associated cancers and about the importance of HPV vaccines, including in males, and expands the scope of a national education campaign about gynecologic cancers to address HPV-associated cancers more broadly and target specific, at-risk populations
• Cancer Care Planning and Communications Act (H.R. 4414) (https://www.congress.gov/bill/117th-congress/house-bill/4414/text): Provides for Medicare coverage and payment for cancer care planning and coordination services for individuals with cancer, including the development of treatment plans, follow-up care, and any necessary revisions
• Prostate Cancer Community Assistance, Research, and Education Act (H.R. 7750) (https://www.congress.gov/bill/117th-congress/house-bill/7750/text): Establishes a committee to develop, implement, and periodically revise a plan to coordinate prostate cancer–focused federal activities and programs, including those related to research, screening, diagnosis, and treatment
• Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667) (https://www.congress.gov/bill/117th-congress/house-bill/1667): Establishes grants and requires other activities to support healthcare providers’ mental and behavioral well-being
• Workplace Violence Prevention for Healthcare and Social Service Workers Act (S. 4182) (https://www.congress.gov/bill/117th-congress/house-bill/1195/text): Issues an interim occupational safety and health standard that requires certain employers to protect personnel from workplace violence
• Preventing Opportunities for Teen E-Cigarette and Tobacco Addiction Act (S. 2974/H.R. 5546) (https://www.congress.gov/bill/117th-congress/senate-bill/2974/text): Requires the Centers for Disease Control and Prevention to develop and implement a specific initiative to prevent and reduce the use of e-cigarettes and emerging tobacco products (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/position-statements/e-cigarettes-and-vaping) among youth and young adults
• Stop Nurse Shortages Act (H.R. 9200) (https://www.congress.gov/bill/117th-congress/house-bill/9200): Supports the development of accelerated nursing programs to increase the number of graduating nurses as a priority area for nurse education, practice, quality, and retention
• Medicare Multi-Cancer Early Detection Screening Coverage Act (S. 1873/H.R. 1946) (https://www.congress.gov/bill/117th-congress/senate-bill/1873): Provides for Medicare coverage and payment for U.S. Food and Drug Administration–approved tests that screen across many cancer types
• Improving Care and Access to Nurses Act (H.R. 8812) (https://www.congress.gov/bill/117th-congress/house-bill/8812): Enhances advanced practice providers’, including oncology nurse practitioners and clinical nurse specialists’, ability to provide certain services under Medicare and Medicaid
• National Nursing Workforce Center Act (S. 4844/H.R. 8817) (https://www.congress.gov/bill/117th-congress/senate-bill/4844): Establishes a pilot program to fund state agencies, state boards of nursing, nursing schools, and other entities to build state-based nursing workforce centers that carry out research, planning, and programs to address nursing shortages, nursing education, and otherwise support the nursing workforce
• Metastatic Breast Cancer Access to Care Act (S. 1312/H.R. 3183) (https://www.congress.gov/bill/117th-congress/senate-bill/1312): Eliminates the five-month waiting period for social security disability insurance benefits and the 24-month waiting period for Medicare coverage for metastatic breast cancer

Oncology nursing advocacy maneuvered many of those bills through the halls of Congress to take significant procedural steps forward, building a solid foundation for the patient advocacy and professional provider communities to return for another attempt. When the bills are reintroduced, oncology nurses must join the chorus (https://voice.ons.org/advocacy/get-involved-in-onss-health-policy-advocacy) to champion them among their congressional representatives.

It may be cliche, but the process is a marathon, not a sprint. In this race, winners are those who continue to compete, recognizing opportunities, and advancing toward the finish line. “The arc of the moral universe is long, but it bends toward justice,” Reverend Martin Luther King, Jr., said (https://www2.oberlin.edu/external/EOG/BlackHistoryMonth/MLK/CommAddress.html). Advocacy follows the same path.