For the past 244 years, the world has envied the Great American Experience. Civics 101 class equipped us with the U.S. checks and balances system’s elementary pillars:

• Government has three equal branches: executive (the president), legislative (the congress), and judiciary (the courts).
• When legislative laws are disputed, the judicial system interprets a law’s constitutionality.

Research and practice changes funded through healthcare legislation have influenced today’s care delivery across all settings: hospitals, clinics, and even homes. And with their constituents laser-focused on health in today’s pandemic society, legislators have never made that happen so quickly.

On June 24, 2022, the Supreme Court of the United States issued its ruling on Dobbs v. Jackson, reversing the decision from the 1973 case, Roe v. Wade. Many nursing, medical, and health organizations issued statements in reaction, and opinions among ONS stakeholders and constituents will differ on the decision. As it leads an organization that represents oncology nurses and advocates for patient-centered care, the ONS Board of Directors reviews social and political issues through the lens of the Society’s mission. With that perspective, the ONS Board believes that two statements from other organizations are important for members to know.

Creating a pathway for policymakers, providers, and the public to understand and recommend a new professional nursing dynamic, the Institute of Medicine’s 2011 Future of Nursing report investigated the current and future state and challenges of the nursing profession.

Since President Joe Biden announced the creation of the Advanced Research Projects Agency for Health (ARPA-H) in October 2021, the National Cancer Institute and National Institutes of Health (NIH) shared responsibility for implementing its goals to improve the U.S. government’s ability to speed biomedical and health research. In April 2022, the U.S. Department of Health and Human Services (HHS) officially placed the agency under NIH.

Amid its celebration of Black Maternal Health Week in April 2022, the U.S. Department of Health and Human Services (HHS) raised awareness of a sobering fact: Black maternal mortality and morbidity are a healthcare crisis throughout the United States.

More than $560 million in provider relief fund (PRF) phase four distribution payments reached more than 4,100 healthcare institutions across the United States in February 2022, according to the U.S. Department of Health and Human Services (HHS). The funding will be used to help healthcare institutions prevent, prepare for, and respond to the COVID-19 pandemic, including maintaining operations at facilities and recruiting and retaining healthcare professionals during the workforce shortage.

Driven by evidence-based practice and patient-centered care, nurses have earned the faith of the American public. For two decades, nurses have been ranked the most trusted and ethical profession in the United States. Although trust is critical, what it lacks is support for the profession through federal investment in research, education, and workforce issues for long-term stability.

To reduce the disparities affecting maternity health outcomes, the U.S. Department of Health and Human Services (HHS) Office on Women’s Health (OWH) launched the Maternal Morbidity and Mortality Data and Analysis Initiative, an $8 million contract with Premier, Inc., the agency announced in December 2021. The initiative is rallying a network of hospitals to deploy evidence-based best practices in maternity care.

Local policies have reduced the availability and youth and adult use of products like flavored e-cigarettes and menthol cigarettes compared to areas without restrictions, the Truth Initiative reported after the first comprehensive quality review that looked at the outcomes of flavor and menthol tobacco restrictions. The research, which was conducted in partnership with the Research Triangle Institute, was published in Nicotine and Tobacco Research.

An investment of nearly $1 billion will help modernize 1,292 Health Resources and Services Administration (HRSA) health center program-funded health centers across the United States, according to an October 2021 announcement from the U.S. Department of Health and Human Services (HHS). The funding will be used to support major healthcare construction and renovation projects and strengthen the country’s healthcare infrastructure.

Preventing overdoses—from any substance, but particularly opioids—is an urgent need during the U.S. opioid epidemic that involves a four-step process: prevention, harm reduction, treatment, and recovery, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra announced. HHS released a new overdose prevention strategy in October 2021 to increase access to services for patients and their families who use substances that can put them at risk for overdose.

Under a newly refreshed strategy, the Centers for Medicare and Medicaid Services’ (CMS) Innovation Center is expanding models in the healthcare industry that reduce program costs and improving quality and outcomes for Medicare and Medicaid beneficiaries, the agency announced in an October 2021 white paper.

After a decade and three legal challenges that culminated in another U.S. Supreme Court decision to uphold the law, the Patient Protection and Affordable Care Act ([ACA], commonly known as Obamacare) is currently established canon. On June 17, 2021, the Supreme Court of the United States (SCOTUS) ruled in favor of the defendants in the case of California et al. v. Texas et al., maintaining ACA’s constitutionality. It was a firm 7-2 decision.

Innovative, affordable, and accountable care are the key to transforming the healthcare system to achieve health equity, according to the Centers for Medicare and Medicaid Services (CMS) Innovation Center’s 10-year plan, which the center announced on August 12, 2021.

U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra celebrated the Children’s Health Insurance Program’s (CHIP’s) 24th anniversary on August 4, 2021, a program that “for more than two decades, has been a lifeline for millions of children and families across America,” with an incredible announcement: in 2020 and 2021, CHIP provided more than 6.8 million enrolled individuals with coverage during the COVID-19 coronavirus pandemic.

In its first year, new presidential administrations release a skinny budget that contains more topline items rather than deep dives into each agency and subdivision. Following suit, in April 2021 the Biden-Harris administration released its request for discretionary funding with limited definition, but it was enough to foreshadow the fiscal year (FY) 2022 funding cycle.

In today’s digital age of news, the public often struggles to decipher real science from misleading or incorrect information—and the COVID-19 coronavirus pandemic has only magnified the situation. Seeing a detrimental impact to the health of the nation, U.S. Surgeon General Dr. Vivek Murthy, MD, MBA, issued his first advisory report of the Biden administration on the topic of misinformation in public health.

As of July 2021, more than 159 million individuals in the United States have been fully vaccinated against the COVID-19 coronavirus, totaling about 48.1% of the U.S. population. However, approximately 173 million others have not, or suggested they will not, receive the vaccination. President Biden’s goal of having 70% of Americans receive at least one vaccine dose and 160 million adults to be fully vaccinated against COVID-19 by July 4, 2021, fell short.

Fifty years ago, President Richard Nixon delivered his third State of the Union address to the U.S. Congress, boldly outlining audacious goals with major federal funding attached. Seeking $100 million for what he deemed “the war on cancer,” Nixon pledged his commitment to invest federal resources in the fight against cancer.

Those without healthcare coverage can now purchase annual policies through state exchanges until August 15, 2021, under the Centers for Medicare and Medicaid Services’ (CMS’s) extended Special Enrollment Period (SEP), ensuring continued access to affordable coverage for Americans during a time of healthcare uncertainty.

In a bipartisan effort that recognizes patients' concerns about telehealth’s accessibility, the U.S. Senate promoted legislation to reduce barriers to care. Senators Brian Schatz (D-HI), Roger Wicker (R-MS), Ben Cardin (D-MD), John Thune (R-SD), Mark Warner (D-VA), and Cindy Hyde-Smith (R-MS), along with 50 colleagues, introduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021. The bill would “expand coverage of telehealth services through Medicare, make permanent COVID-19 telehealth flexibilities, improve health outcomes, and make it easier for patients to safely connect with their doctors.”

On April 28, 2021, in his first congressional address to the U.S. Congress, President Joe Biden proposed another major piece of legislation to put the country back on a path to enhance public health and promote economic growth. It was the latest in a series of bills from the new administration that have implications for oncology nurses and patients with cancer. 

Structural racism is repeatedly linked to health disparities, but a new agency report outlines plans to address discrimination and improve patient outcomes. In a special 2021 supplement to the journal Ethnicity and Disease, “Structural Racism and Discrimination: Impact on Minority Health and Health Disparities,” the National Institute on Minority Health and Health Disparities published a series of reports exploring the relationships between policies, practices, and health. It also included recommended solutions, including outcomes from interventions in a school district and a local health department and future research directions (e.g., examining ways racism embedded in online systems can contribute to health disparities).

In May 2021, U.S. Representative Lauren Underwood, RN (D-IL), introduced the Primary and Behavioral Health Care Access Act that, if passed, would require private health insurance plans to cover three primary care visits and three behavioral health or substance abuse disorder visits per year without cost sharing. Underwood’s goal was to promote legislation that would make health care more accessible and affordable. 

Society in 2021 has been challenged by an economic crisis and the COVID-19 coronavirus pandemic. Today, nurses must have an arsenal of tools and knowledge—and the ability to adapt in unpredictable circumstances—to assist patients seeking health care.

A shining light to guide a burgeoning field—often referred to as “the lady with the lamp”—Florence Nightingale was a revolutionary figure in nursing, transforming care by simple but radical actions. Through scientific research she showed that sanitation and healthy diets improved patient outcomes, and through advocacy she fought for access to those conditions for all of her patients. She modeled the way for nurse advocates throughout history and into today. 

On March 22, 2021, Xavier Becerra, BA, JD, became the first Latino appointed as secretary of the U.S. Department of Health and Human Services (HHS), and announced the agency’s focus on ensuring affordable and accessible health care for every American. 

With the aging population of clinicians and patients, nursing is in desperate need of a stronger workforce. To advance nurses at all levels of practice, on February 9, 2021, the U.S. House Committee on Energy and Commerce announced its plan to increase funding for the Nurse Corps Loan Repayment Program by $200 million through its section of the American Rescue Plan.

Although not expressly written as part of the U.S. Constitution, from the earliest days of the republic, strong presidents have issued proclamations, instructions, and statements that eventually evolved into executive orders carrying the weight of the federal government on new directives meant to change policy. George Washington issued his first presidential edicts to have his Cabinet report on departmental activities. 

Three nurses serve in the U.S. Congress, and the profession briefly added one more federal representation at the agency level as well. President Joe Biden appointed Rear Admiral Susan Orsega, MSN, RN, FNP-BC, FAANP, FAAN, a nurse practitioner, as acting surgeon general while Vivek H. Murthy, MD, MBH, who served as former president Barack Obama’s surgeon general, was waiting for Senate confirmation. The position is often referred to as the “nation’s doctor,” although Orsega was the third nurse to hold the title before Murthy assumed his current post.

Although society has tried to take steps to confront gender disparities, women remain underrepresented across various sectors. Title IX in 1972 granted every American student the right to education without gender discrimination. However, female students still bear the brunt of sex-segregated programs and gender-based violence, two major obstacles to educational equality. Women consistently earn less than their male counterparts. The wage gap is larger for most women of color, and gender discrimination and sexual harassment in the workplace perpetuate economic divides. More women work today than ever before, but they face barriers to leadership roles, such as stereotypes about their performance abilities, uneven demands of motherhood compared to male partners, and the reality that many workplaces prefer and reward masculine leadership styles. Health needs are substantially greater for older women compared to older men, but women reported fewer visits with a physician and lesser likelihood to stay in a hospital. 

The COVID-19 coronavirus pandemic has changed the world as we know it. The mortality rate is devasting, the economic impact is jarring, and no one can pinpoint any date for its end. But new vaccines offer a glimmer of hope—but only if the country can settle discussions about achieving adequate vaccination coverage and strategies to distribute and inoculate hundreds of millions of people.

More nurses are diagnosed with the COVID-19 coronavirus than healthcare providers in any other discipline. Despite that sober statistic, very few congressional committees’ COVID-19 legislation proposals support essential workers like nurses. U.S. Representatives Jackie Speier (D-CA) and Joe Neguse (D-CO) introduced a bill to address those concerns.  

For its advocacy approach to the 117th U.S. Congress that convened in January, ONS increased its emphasis on palliative care and patient access, developing its 2021 health policy agenda to reflect the evolving healthcare legislation landscape. 

President Joe Biden made several campaign promises to improve or safeguard health care for all Americans with a focus on scientific and medical evidence. Shortly after the transfer of power, the Biden administration appointed and nominated public health experts to lead the various federal agencies dedicated to safety and biomedical research. 

Through two letters—one to President Joe Biden and Vice President Kamala Harris and another to U.S. Senate and House leaders—the Nursing Community Coalition, on whose steering committee ONS sits, congratulated policymakers while outlining the need for continued support of nurses in health care. 

As the country sees dramatic spikes in COVID-19 coronavirus cases in fall 2020, political leaders are seeking to find solutions to deliver personal protective equipment (PPE) to healthcare workers on the front lines. U.S. Senator Tammy Baldwin (D-WI) introduced the Protect Our Heroes Act of 2020 to increase the production of PPE and spur oversight into the supply and distribution of these necessary medical supplies. 

The Biden transition team needs full cooperation and all critical information regarding the COVID-19 coronavirus, he American Medical Association (AMA), American Hospital Association (AHA) and American Nurses Association (ANA) said in a November 2020 letter to the Trump administration.  

October 31, 2020, marked an important milestone in American public health: the 80th anniversary of President Franklin Delano Roosevelt’s dedication of the campus of the National Institutes of Health (NIH) in Bethesda, MD. 

In 2020, the number of middle and high school students who use e-cigarettes decreased by 1.8 million compared to 2019, the Centers for Disease Control and Prevention and U.S. Food and Drug Administration reported in the results of the 2020 National Youth Tobacco Survey. However, the results also showed that youth tobacco use is still an epidemic in the United States.

Like cancer, viruses know no political parties, no country boundaries, and no personal attributes. As the COVID-19 coronavirus spread in an infectious wave across the earth in record time, it decimated economies and devastated populations. To defend their countries against an invisible enemy, governments around the world stepped in with unprecedented command.

The global COVID-19 coronavirus pandemic has forced elected officials and political leaders to reevaluate the provision of health care in the United States. To address inequal access to care and representation among health professionals, on April 24, 2020, U.S. Representative Jan Schakowsky (D-IL) and Democratic Whip and U.S. Senator Dick Durbin (D-IL) introduced the Health Heroes 2020 Act, a bicameral piece of legislation.

When standing up for patients, championing treatments, or stopping an unfair process, nurses speak truth to power. Being on the front lines is part of every nurse’s routine, but many shy away from engaging in the policy world under similar circumstances that affect the profession, patients, and peers. It doesn’t have to be that way. Nurses can educate themselves on the candidates and policy issues and lend their voice to the political conversation.

On April 1, 2020, the U.S. House of Representatives Subcommittee on Economic and Consumer Policy asked the U.S. Food and Drug Administration (FDA) to clear the market of e-cigarettes because of the COVID-19 coronavirus pandemic. It was responding to FDA’s request to give e-cigarette manufacturers four additional months to submit applications to stay on the market before enforcing a ban.  

The public push for a transformation in tobacco policy began with a persistent legislator seeking real change. Opening his historic congressional hearing in 1994, U.S. House of Representatives Energy and Commerce Committee Chair Henry Waxman (D-CA) said, “The truth is that cigarettes are the single most dangerous consumer product ever sold. Nearly a half million Americans die every year as a result of tobacco. This is an astounding, almost incomprehensible statistic. Imagine our nation’s outrage if two fully loaded jumbo jets crashed each day, killing all aboard. Yet that is the same number of Americans that cigarettes kill every 24 hours. Sadly, this deadly habit begins with our kids. Each day 3,000 children will begin smoking. In many cases they become hooked quickly and develop a life-long addiction that is nearly impossible to break.” 

A day after President Donald Trump was considering lifting some of the quarantine mandates, healthcare leaders from the American Hospital Association, American Medical Association and American Nurses Association (ANA) released an open letter urging Americans to stay home.

Change at the federal level takes time and perseverance. Thanks to great effort from the smoking cessation community—including ONS—the federal government is updating package and advertising warning for tobacco products for the first time since 1984. Advocates have been calling on agencies to exercise authority over tobacco products along with their marketing and distribution, and on March 17, 2020, the U.S. Food and Drug Administration (FDA) issued a final rule requiring new health warning labels for cigarette packages and advertisements.

The alarmingly quick spread of the COVID-19 coronavirus has put a strain on the U.S. healthcare system, including the availability of personal protective equipment and other safety resources. The speed at which the virus spreads requires an even swifter response from federal agencies, government officials, and public health experts to combat the disease. To cut the red tape and accelerate data collection, the Department of Health and Human Services (HHS) has used statutory authority under the Paperwork Reduction Act to survey Health Resources and Services Administration healthcare institutions to understand the current COVID-19 response, challenges institutions are facing, and ways to help.

Drug pricing is a top legislative issue for Congress, and amid rising COVID-19 concerns, health policy topics are more pressing than ever. On March 5, Senator Martha McSally (R-AZ) introduced the Lowering Prescription Drug Prices for America’s Seniors and Families Act of 2020, which would allow Medicare to negotiate prices after a drug’s patent expires as well as cap out-of-pocket prescription spending for seniors at $3,100 per year.