Congressional Democrats want to pump $50 billion into the training and hiring of more public health nurses ― a cash infusion they say would improve both working conditions for nurses and health outcomes for underserved communities.
Lawmakers planned to introduce bills in both the House and Senate on Wednesday to establish a grant program for nurse jobs through the Centers for Disease Control and Prevention. The legislation calls for funding of $5 billion a year for the next decade.
The money would be doled out to state, tribal and local health departments to recruit and pay registered nurses, prioritizing areas with high rates of chronic disease and mortality or poor access to health care.
The effort is being led by Rep. Melanie Stansbury (D-N.M.) in the House and Sen. Ed Markey (D-Mass.) in the Senate.
“Part of why people are leaving the workforce is they’re burned out. In many instances they feel like they’re not being valued.”
– Rep. Melanie Stansbury (D-N.M.)
Stansbury said in an interview that the legislation could “transform nursing” at a time when many nurses have felt overworked, burned out, and underpaid since the COVID-19 pandemic began. She noted that rural areas of New Mexico, particularly, have struggled to attract and retain enough health care workers.
“You hear it everywhere you go… The wait times in some cases are months or even into the next year,” she said. “It truly is in a crisis.”
Stansbury said she saw the understaffing problem up close last year when her mother was waiting to have heart surgery done at an Albuquerque area hospital. The procedure was delayed 72 hours as they waited for a bed.
“It was no fault of the hospital or the wonderful nurses and doctors who did care for her,” she said. “It was the actual shortage of staff that led to the delay and a really traumatic experience we had.”
Markey said in a statement that the pandemic “laid bare the cracks in the foundation of our public health infrastructure, and it’s long past time we build it back up.”
Hospitals and health systems have said they are struggling to find enough workers, citing a “shortage” that forced them to compete with one another and pay higher rates for travel nurses. But many nurses say there are plenty of them to go around, just not at the pay rates and schedules that health care providers have come to expect.
The union National Nurses United (NNU) says there is a “staffing crisis,” not a shortage, with many nurses tempted to leave for other fields “after repeatedly working under conditions that are unsafe for themselves and their patients.” Thousands of nurses and other health care workers have gone on strike in recent months, demanding higher pay and staffing levels.
Democrats’ nursing bill requires that any grantees either have a collective bargaining agreement in place or agree not to fight a union organizing drive. Such a “neutrality” provision could help pave the way to unionization in state or local government agencies that accept the funding to train and pay nurses. The bill has the backing of NNU and other unions that represent health care workers.
“Part of why people are leaving the workforce is they’re burned out,” Stansbury said. “In many instances, they feel like they’re not being valued.”
The Republicans who control the House are highly unlikely to go along with that stipulation, or the bill at all, given its $5 billion a year cost. Republicans have generally opposed health care funding increases despite the crises facing rural hospitals in particular. As Stansbury put it, “There’s a lot of intractability [in Congress] around things that cost money.”
But she said she hoped the proposal could get roped into a larger legislative package that passes, pointing to last year’s Inflation Reduction Act. That bill, signed by President Joe Biden, included several provisions related to prescription drugs and Medicare. Democrats still controlled the House at the time and muscled the bill through the Senate on a party-line vote that circumvented the filibuster.
Stansbury described the bill as “a surge of funding to get nurses and health care workers into our communities at the grassroots level.”
She said, “We don’t have an alternative. This is literally a life-or-death matter for our communities that we address these health care shortages.”