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March 16, 2023
President Proposes Boost in Nurse Education Funding
Federal nursing workforce development programs would see a $49.5 million increase in fiscal year 2024 funding under the $6.9 trillion budget proposed by President Joe Biden. The proposed boost in Title VIII programs to a total of $349.9 million includes a $32 million increase to expand nursing education programs, including increasing the number of nurse faculty and clinical preceptors, and an increase of $17 million for the Advanced Nursing Education program to grow and diversify the maternal and perinatal health nursing workforce. The budget also proposes $28 million for a new program to address health care workforce shortages and “stimulate and develop innovative approaches to recruiting, supporting, and training new providers, with an emphasis on meeting the needs of underserved communities.”
The president’s spending plan is a sharp contrast to congressional Republicans’ priorities, with House Republicans promising to pass a 2024 budget that drops spending back to fiscal year 2022 levels – an overall cut of more than $130 billion. The next step in the appropriations process will be efforts to pass a fiscal year 2024 budget resolution laying out Congress’s spending targets. House Republican leaders have already said they won’t meet the statutory April 15 deadline to adopt a budget resolution, but appropriators hope to start marking up bills in committee during May.
Little Progress as Debt Limit Deadline Nears
With analysts warning that the Treasury Department will run out of borrowing options this summer, Democrats and Republicans remain far apart on plans for the federal government to avoid defaulting on the nation’s $31.46 trillion debt. Congressional Republicans continue to demand sweeping reductions in federal spending as part of a deal to raise the debt limit, while the White House and Democrats on Capitol Hill call for a “clean” debt limit increase separate from any negotiations on spending decisions. There’s been no progress in debt limit negotiations – President Biden and Speaker McCarthy haven’t met since their initial talk a month ago and nothing is scheduled. The government is projected to face defaulting on the debt sometime between early June to mid-August and the lack of progress is raising the possibility of a short-term suspension of the debt limit.
House Republicans are expected to pass legislation that would allow the government limited borrowing authority to cover defense and veterans’ spending but prioritize other payments. The “Default Prevention Act” (H.R. 187) is opposed by Democrats concerned that Republicans will push for cuts in Medicaid and other health programs, potentially including phasing out enhanced federal payments to states, capping funding through block grants or per-capita caps, abolishing the Affordable Care Act’s Medicaid expansion, and adding work requirements to qualify for Medicaid coverage.
Nurses Face End of Pandemic Practice Waivers
With less than two months to the May 11 end of the federal COVID-19 national and public health emergencies, nurses are facing the expiration of a number of pandemic waivers that lifted barriers to practice and enabled them to provide care for patients more reflective of their education and clinical preparation. Federal regulators are unwilling to extend those waivers after the emergencies end, including policies that enable Medicare patients to be admitted to hospitals without physician authorization, eliminate the requirement that a physician be present in critical access hospitals, and waive physician supervision in federally qualified health centers. The NLN has joined other nursing organizations in urging Congress to take action to eliminate those practice barriers.
The latest concern related to the end of the public health emergency comes from two rules proposed by the Drug Enforcement Administration that would limit the ability of APRNs and other providers to prescribe controlled substances for opioid and substance abuse by telehealth – proposals that have been widely criticized by members of Congress and health care providers. |
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