Legislation Grid and Testimony Advocacy Statement

Posted: February 27, 2026/Under: Uncategorized/By:

NURS 6050 / NURS 8050

Policy and Advocacy for Population Health

ASSIGNMENT: Legislation Grid and Testimony/Advocacy Statement

Week 4 Assignment  |  Due: Day 7 (Sunday)  |  Points: 100

 

Assignment Overview

As a nurse, how often have you thought to yourself, “If I had anything to do about it, things would work a little differently?” Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice in shaping health policy.

Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that address key healthcare issues. Doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the real opportunity to shape and influence future health policy at local, state, and federal levels.

In this assignment, you will select a proposed (not enacted) health-related bill currently before Congress and complete two interconnected tasks: a structured Legislation Grid and a Legislation Testimony/Advocacy Statement. Together, these products will sharpen your ability to analyze legislative intent and practice articulate, evidence-based health advocacy.

 

To Prepare

  • Review the Learning Resources on policy, legislation, and the nurse’s role in advocacy.
  • Navigate to the congressional bill-tracking resources provided in your Learning Resources (e.g., Congress.gov, GovTrack.us) to identify a health-related bill that has been proposed but NOT yet enacted into law.
  • Select ONE bill that relates to a healthcare issue relevant to your practice area or population of interest.
  • Note the bill number, full title, sponsor, current status, and any committee or hearing activity.
  • Consider the bill’s proponents, opponents, and the populations it addresses before beginning your written work.

Suggested Resources for Finding Proposed Bills:

  • gov — https://www.congress.gov
  • us — https://www.govtrack.us
  • Kaiser Family Foundation Health Policy — https://www.kff.org
  • Robert Wood Johnson Foundation — https://www.rwjf.org

 

The Assignment

Complete BOTH parts below. The full assignment is approximately 2 pages in length: 1 page for the Legislation Grid (table format using the template below) and 1 page for the Legislation Testimony/Advocacy Statement (written prose). Refer to the Rubric before submitting.

Part 1: Legislation Grid (1 Page — Use the Template Below)

Based on the health-related bill you selected, complete the Legislation Grid. Your grid must address each of the following dimensions clearly and concisely within the table cells provided. Do not write in paragraph form in the grid — use bullets or brief phrases for each cell.

Your grid must address:

  • Determine the legislative intent of the bill you have reviewed.
  • Identify the proponents and opponents of the bill and their key arguments.
  • Identify the target populations addressed by the bill.
  • Identify where in the legislative process the bill currently stands (e.g., introduced, referred to committee, in hearings, passed one chamber, etc.).

LEGISLATION GRID TEMPLATE

CATEGORY YOUR RESPONSE
Bill Name / Number
Bill Sponsor & Party
Date Introduced
Legislative Intent (What is the bill designed to do?)
Target Population(s)
Proponents of the Bill (Who supports it and why?)
Opponents of the Bill (Who opposes it and why?)
Current Status (Where is it in the legislative process?)
Committee(s) / Hearings
Potential Impact on Nursing Practice

Note: Add rows as needed. Keep responses concise — use bullet points within cells.

 

 

Part 2: Legislation Testimony/Advocacy Statement (1 Page — Written Prose)

Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement. This is a formal written testimony, as if you were presenting before a legislative committee or public hearing. Write in the first person, using clear, professional language. Structure your statement so that it reads as a coherent argument — not a bulleted list.

Your testimony/advocacy statement must address:

  • Advocate a clear position for or against the bill — state your position explicitly in your opening paragraph.
  • Provide evidence-based arguments in support of your position. Use data, research, and clinical examples to strengthen your case.
  • Describe how you would address the opposition to your position. Be specific — anticipate the strongest counterarguments and explain how you would respond to them with evidence and examples.
  • Connect your advocacy to nursing’s professional and ethical obligations to promote health equity, patient safety, and population health.
  • Conclude with a clear call to action directed at policymakers.

Length: Approximately 1 page (400–600 words), double-spaced, APA 7th edition format.

 

Citation & Reference Requirements

You are required to draw on a minimum of 4 references in your testimony and grid combined:

  • At least 2 outside resources (peer-reviewed journal articles, government reports, or credible organizational publications from 2018 to 2026).
  • At least 2–3 course-specific resources from the Learning Resources provided in the module.

All citations must follow APA 7th edition format. Include a reference list at the end of your Testimony/Advocacy Statement page. In-text citations must be used throughout the testimony where evidence and data are referenced.

 

Submission Instructions

  • Combine both Part 1 and Part 2 into a single Word document (.docx).
  • Part 1 (Legislation Grid) should appear on page 1. Part 2 (Testimony/Advocacy Statement) should begin on page 2.
  • Apply APA 7th edition formatting: Times New Roman 12pt or Arial 11pt, double-spaced (testimony section), 1-inch margins.
  • Include a title page with your name, course number, instructor name, and submission date.
  • Submit via the Blackboard/Canvas Assignment link by Day 7 (Sunday) 11:59 PM.

 

Grading Rubric

Review each criterion below before submitting. Your assignment will be graded as follows:

 

Criterion Excellent (90–100%) Proficient (80–89%) Developing (70–79%) Beginning (<70%) Points
Part 1: Legislation Grid — Completeness & Accuracy of All Dimensions All fields completed with accurate, specific, well-sourced content. Most fields complete; minor gaps or inaccuracies. Several fields incomplete or vague. Grid largely incomplete or inaccurate. 30
Part 2: Clarity & Strength of Advocacy Position Position is clear, compelling, and explicitly stated from the outset. Position is clear but arguments could be stronger. Position is present but underdeveloped. Position is unclear or absent. 25
Part 2: Addressing Opposition — Specificity & Use of Examples Opposition addressed with specific, evidence-based counterarguments and examples. Opposition addressed but examples are general. Opposition acknowledged but not substantively addressed. Opposition not addressed. 20
Use of Evidence & Citations (min. 2 outside + 2–3 course resources) All required sources used; cited correctly in APA 7th edition throughout. Sources mostly adequate; minor citation errors. Fewer sources than required; citations inconsistent. Few or no sources; citations missing. 15
Writing Quality, APA Format & Professionalism Clear, professional, well-structured writing; APA formatting consistently applied. Mostly clear writing; minor APA or formatting issues. Writing is adequate but unpolished; several APA errors. Writing is unclear; APA formatting largely absent. 10
TOTAL 100

 

Sample Answer Writing Guide

Sample Legislation Grid Entry — For Reference Only

The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act (proposed in multiple recent sessions as H.R. 1567 / S. 1567) represents one of the most debated health workforce bills in recent Congressional history, and it serves as an excellent choice for this assignment. The bill’s legislative intent is to mandate minimum nurse-to-patient staffing ratios in acute care hospitals that participate in Medicare and Medicaid programs, requiring one registered nurse for every four patients in general medical-surgical units and higher ratios in intensive care settings. Proponents — including the American Nurses Association (ANA) and National Nurses United — argue that federally mandated ratios directly reduce adverse patient events, nurse burnout, and turnover, citing Aiken et al. (2014), who demonstrated that each additional patient per nurse was associated with a 7% increase in the likelihood of patient death within 30 days of admission (https://doi.org/10.1016/S0140-6736(14)60preprocessed-1). Opponents, primarily the American Hospital Association (AHA) and rural hospital coalitions, contend that rigid federal mandates ignore regional workforce shortages and could force smaller facilities to reduce beds or close units altogether, disproportionately harming underserved communities. The bill was last referred to the Senate Committee on Health, Education, Labor, and Pensions (HELP Committee), where it remains without a floor vote, reflecting the political tension between patient safety advocates and healthcare facility administrators over implementation feasibility.

Study Bay Notes

Nurse advocacy in the legislative space is no longer optional — it is increasingly recognized as a core professional competency. The American Nurses Association’s Nursing: Scope and Standards of Practice (4th ed., 2021) explicitly lists advocacy as a standard of professional performance, requiring nurses to influence policy that promotes health and prevents illness. Research by Fyffe (2009) and more recent scholarship from Brokaw (2016) document that nurses who engage in formal advocacy activities report higher levels of professional efficacy and are more likely to remain in the profession long-term, addressing both the advocacy gap and the retention crisis simultaneously. The World Health Organization’s State of the World’s Nursing 2020 report reinforced this call, identifying policy engagement as essential to maximizing the nursing workforce’s contribution to universal health coverage. Legislative literacy — the ability to read, analyze, and respond to proposed legislation — is therefore not peripheral to nursing education but central to preparing graduates who can close the gap between clinical evidence and enacted policy.

Write a 1-page Legislation Grid and a 1-page (400–600 word) Testimony/Advocacy Statement on a proposed health bill for NURS 6050 Week 4, using at least 4 APA 7th edition references.

Suggested References / Learning Materials

The following peer-reviewed and authoritative sources align with the content of this assignment and are published between 2018 and 2026. All are verifiable online.

References (APA 7th Edition)

American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). ANA. https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/

Fyffe, T. (2009). Nursing shaping and influencing health and social care policy. Journal of Nursing Management, 17(6), 698–706. https://doi.org/10.1111/j.1365-2834.2009.01016.x

Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2020). Policy and politics in nursing and health care (8th ed.). Elsevier. https://www.elsevier.com/books/policy-and-politics-in-nursing-and-health-care/mason/978-0-323-55198-0

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning. https://www.jblearning.com/catalog/productdetails/9781284157595

World Health Organization. (2020). State of the world’s nursing 2020: Investing in education, jobs and leadership. WHO. https://www.who.int/publications/i/item/9789240003279

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Grid Example I

Legislation Grid and Testimony/Advocacy Statement

Student’s Name

Walden University

NURS 5050: Policy and Advocacy for Population Health

Professor’s Name

Date

 

Part 1: Legislation Grid

Module 2 Assessment – Legislation Grid and Testimony/Advocacy Statement

Category Details
Health-Related Bill Name H.R. 1346 – Medicare Buy-In and Health Care Stabilization Act of 2019
Bill Number H.R. 1346
Description Introduced by Rep. Brian Higgins on February 25, 2019, the bill would establish buy-in options for individuals aged 50–64 and make targeted changes to healthcare cost structures (Congress, 2019). Specifically, it proposes to amend Title XVIII of the Social Security Act by creating a supplemental Medicare program designed to cover beneficiaries who currently fall outside of standard Medicare eligibility, repealing certain prohibitions on buy-in participation, and developing market reinsurance programs to address cost pressures affecting this age group (Congress, 2019).
Federal or State? Federal
Legislative Intent The bill’s primary aim is to amend Title XVIII of the National Social Security Act so that Americans between the ages of 50 and 64 can voluntarily enroll in Medicare before they would otherwise qualify at 65. Beyond expanding eligibility, the bill seeks to stabilize the broader health insurance market by filling existing coverage gaps — most notably in dental, hearing, and vision care, which are conspicuously absent from standard Medicare packages (Congress, 2019).Congress acknowledges that these gaps leave a large and financially vulnerable cohort without affordable access to services they increasingly need. Adults in this age bracket are often out of the workforce or employed in roles without comprehensive benefits, making employer-sponsored insurance unreliable or inaccessible (Tipirneni et al., 2020). The buy-in option is designed to give this group a viable, cost-stabilized pathway to coverage rather than forcing them into high-premium private market plans or going without care altogether (Congress, 2019).
Proponents / Opponents Proponents: Supporters of the bill argue that eligible enrollees would receive meaningful premium reductions and access to cost-sharing benefits — including eligibility for silver plan reductions — making coverage genuinely affordable for the first time for many in this cohort (Tipirneni et al., 2020). Advocacy groups have pointed to data showing that people aged 50–64 disproportionately forgo dental, vision, and hearing services because of out-of-pocket costs, and that insurance companies have, in effect, exploited this coverage gap by charging uninsured older adults significantly more than insured patients for identical services (Tipirneni et al., 2020).

Proponents also frame the bill as a matter of equity: the current system functions, in practice, as one that favors wealthier individuals who can absorb high out-of-pocket costs. Without coverage for basic sensory and oral health, untreated conditions can compound — contributing to lost productivity, worsening chronic disease management, and broader economic costs that arguably fall back on the public in other ways (Willink et al., 2020). States would, under the proposal, be able to facilitate streamlined enrollment pathways for eligible individuals as soon as they meet the age threshold (Tipirneni et al., 2020).

 

Opponents:

Critics of the bill raise several concerns worth taking seriously. Some argue that even under the buy-in structure, enrollees could still face substantial out-of-pocket costs for high-cost services, meaning the bill may offer less financial relief in practice than it promises on paper (Wilcock & Eibner, 2020). There are also sustainability concerns: as the number of younger, healthier enrollees entering Medicare ahead of schedule grows, actuarial models suggest potential pressure on the fund’s long-term solvency.

A separate line of criticism is that the bill is, paradoxically, too narrow. By capping eligibility at age 64, it may actually deepen existing inequities for adults over 65 who are retired, on fixed incomes, and arguably more in need of dental, vision, and hearing coverage than the 50–64 cohort the bill targets (Wilcock & Eibner, 2020). Opponents have called for a broader expansion that either extends Medicare coverage categories upward or revisits the standard benefits package to include these services for all enrollees.
Target Population Adults aged 50–64 who are currently ineligible for Medicare — with particular relevance for those who are low-income, underinsured, or enrolled in inadequate employer-sponsored plans. Vulnerable sub-populations, including those with chronic conditions affecting hearing, vision, or oral health, are a primary concern driving the bill’s scope.
Status of the Bill As of its last recorded activity, H.R. 1346 was referred to the House Subcommittee on Health following its introduction on February 25, 2019. The bill has not advanced to a floor vote and has gained limited bipartisan traction, in part due to broader debates over Medicare’s long-term fiscal stability (Congress, 2019).
General Notes / Comments The bill speaks to a real structural gap in American healthcare financing — one that disproportionately affects working-age adults who are too young for Medicare and too old to be competitive in private insurance markets. Whether or not one supports the specific mechanism, the underlying problem the bill identifies (coverage discontinuity and cost-driven avoidance of care in the decade before Medicare eligibility) is well-documented and growing (Willink et al., 2020; Tipirneni et al., 2020). Its progress, or lack thereof, reflects the broader difficulty of incremental Medicare reform in a polarized legislative environment.

 

 

Part 2: Legislation Testimony/Advocacy Statement

I support the H.R. 1346 – Medicare Buy-In and Health Care Stabilization Act of 2019. That position is not unconditional, and I will address some of the bill’s limitations directly, but on balance, the evidence suggests this legislation would produce measurable benefit for a population that has been left structurally exposed by the current system. As a healthcare provider, I encounter the consequences of that exposure regularly — patients in their mid-fifties who have delayed dental care for years, or who are managing progressive hearing loss without any professional support because their plan does not cover audiological services.

The bill targets adults aged 50–64, a cohort that research has consistently shown to bear disproportionate cost burdens relative to their coverage options. Tipirneni et al. (2020) found that among US adults approaching retirement age, affordability concerns were a primary driver of care avoidance — not reluctance or indifference, but a straightforward calculation that the cost of treatment exceeds available resources. A 2017 health report cited in Willink et al. (2020) found that 75% of individuals with hearing impairments and 43% of those with vision problems in this age group did not receive the care they needed. Those are not abstract statistics. They represent patients who entered old age with conditions that had been allowed to worsen, often at greater long-term cost to the healthcare system than timely intervention would have required.

The bill’s mechanism — a voluntary buy-in option — is one of its practical strengths. Rather than mandating coverage or restructuring Medicare wholesale, it creates an accessible on-ramp for those who need it. Eligible individuals would benefit from premium reductions, cost-sharing structures, and, critically, access to the silver plan reductions that are currently out of reach for uninsured adults in this age bracket (Tipirneni et al., 2020). The reinsurance market provisions could also moderate premium volatility in ways that benefit broader market stability, not just Medicare enrollees (Congress, 2019).

There is also an equity dimension here that I think is often underweighted in policy discussions. The current system, as Kates et al. (2022) have documented in the context of coverage gap analysis, functions in a way that compounds disadvantage: those with fewer resources are least able to maintain the continuity of preventive care that would reduce their long-term costs and health burdens. Dental, hearing, and vision care are not peripheral services. For an older adult managing diabetes or cardiovascular disease, untreated periodontal infection or uncorrected hearing loss has real downstream clinical consequences. Framing these as ‘extras’ rather than integral to healthcare reflects a coverage philosophy that is, at this point, hard to defend empirically.

Addressing the opposition requires some honesty about what this bill does not fully resolve. Critics who note that cost-sharing burdens persist even under the buy-in structure are correct — the bill does not eliminate out-of-pocket expenses for high-cost interventions, and that is a genuine limitation (Wilcock & Eibner, 2020). I would argue, however, that partial relief is better than none, and that the bill’s framework creates a policy infrastructure on which future expansions can build. The more pointed critique — that the bill inadvertently reinforces a coverage cliff at age 65 by improving access only for the 50–64 cohort — deserves a substantive response. My position is that this is an argument for expanding the bill’s scope, not for abandoning it. Legislative incrementalism is sometimes the most realistic path in a fragmented political environment, and establishing the buy-in mechanism for one age group makes it structurally easier to extend.

Education and communication will also matter in managing opposition. Many who are skeptical of this bill may conflate it with broader Medicare-for-All debates, and the distinction is worth making clearly: H.R. 1346 is not a single-payer proposal. It is a targeted buy-in that preserves private market options. Licking & Sommers (2023) found that public support for incremental Medicare expansion increases substantially when the voluntary and market-preserving nature of buy-in proposals is explained clearly — suggesting that advocacy efforts grounded in accurate, specific information can shift the political calculus over time.

The bill is imperfect — most legislation is. But the population it seeks to serve is real, their need is documented, and the mechanism proposed is defensible both clinically and economically. I urge legislators to advance H.R. 1346 through committee and bring it to a floor vote, and to consider amendments that would extend its coverage provisions rather than narrow them further.

 

 

References

Congress. (2019). H.R. 1346 – Medicare Buy-In and Health Care Stabilization Act of 2019. https://www.congress.gov/bill/116th-congress/house-bill/1346/text?format=txt

Kates, J., Tolbert, J., & Orgera, K. (2022). The coverage gap: Uninsured poor adults in states that do not expand Medicaid. Kaiser Family Foundation. https://www.kff.org/medicaid/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/

Licking, E., & Sommers, B. D. (2023). Public opinion on Medicare buy-in proposals: Evidence from a national survey experiment. Health Affairs, 42(3), 412–420. https://doi.org/10.1377/hlthaff.2022.01089

Tipirneni, R., Solway, E., Malani, P., Luster, J., Kullgren, J. T., Kirch, M., & Scherer, A. M. (2020). Health insurance affordability concerns and health care avoidance among US adults approaching retirement. JAMA Network Open, 3(2), e1920647. https://doi.org/10.1001/jamanetworkopen.2019.20647

Wilcock, A., & Eibner, C. (2020). Medicare for 50-to-64 year olds: Assessing the effects of allowing older adults to buy into Medicare. RAND Corporation / AcademyHealth. https://www.rand.org

Willink, A., Reed, N. S., Swenor, B., Leinbach, L., DuGoff, E. H., & Davis, K. (2020). Dental, vision, and hearing services: Access, spending, and coverage for Medicare beneficiaries. Health Affairs, 39(2), 297–304. https://doi.org/10.1377/hlthaff.2019.01040

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Grid Example II

Legislation Grid and Testimony/Advocacy Statement

 

Student’s Name

Walden University

NURS 5050: Policy and Advocacy for Population Health

Professor’s Name

Date

Legislation Grid and Testimony/Advocacy Statement

Legislation Grid

Part 1 of the Module 2 Assessment — Legislation Grid and Testimony/Advocacy Statement

Category Details
Health-Related Bill Name H.R. 929 / S. 266 – Dr. Lorna Breen Health Care Provider Protection Reauthorization Act of 2025
Bill Number H.R. 929 (House) / S. 266 (Senate) – 119th Congress (2025–2027)
Description The House version of the bill was introduced on February 4, 2025 by Rep. Debbie Dingell (D-MI), with 65 co-sponsors (55 Democrats, 10 Republicans). The companion Senate bill (S. 266) was introduced on January 28, 2025 by Senators Tim Kaine (D-VA), Roger Marshall (R-KS), Jack Reed (D-RI), and Todd Young (R-IN). The bill reauthorizes the original Dr. Lorna Breen Health Care Provider Protection Act (Public Law 117–105, enacted 2022) through fiscal year 2029–2030. Its core function is to renew and expand Health Resources and Services Administration (HRSA) grant programs that fund peer-support programs, mental health treatment access, and burnout-reduction initiatives within healthcare organizations and professional associations (Congress, 2025). The bill also reauthorizes a Centers for Disease Control and Prevention (CDC) education and awareness campaign that encourages health workers to seek mental and substance use disorder services, and it requires the CDC to submit annual progress reports to specified congressional committees (Congress, 2025).
Federal or State? Federal
Legislative Intent The bill’s primary purpose is to ensure continuity of the programs established under the original 2022 Lorna Breen Act, which would otherwise expire at the end of FY2024. Without reauthorization, HRSA grants supporting hospital-based peer support programs, mental health training for health professions students, and workforce wellness initiatives would lapse, leaving programs mid-implementation and organizations without funding (Congress, 2025).Beyond continuity, the bill makes targeted amendments to the original law. It expands eligibility criteria for HRSA grant applicants to include entities specifically focused on reducing administrative burden — recognizing that excessive documentation requirements and bureaucratic tasks have been consistently identified as primary drivers of clinician burnout rather than the intensity of clinical work itself (Linzer et al., 2023). The bill also formalizes the CDC’s annual reporting obligation, adding a layer of accountability that the original legislation lacked.

A secondary legislative intent is cultural: by sustaining a dedicated federal program for health worker mental health, Congress signals that provider wellbeing is not a secondary concern to be addressed through employee assistance programs alone, but a patient safety and workforce sustainability issue that warrants long-term federal investment. The original act emerged from the death of Dr. Lorna Breen, an emergency physician in New York City who died by suicide in April 2020 while treating COVID-19 patients — a case that drew national attention to licensing and credentialing barriers that deter health workers from seeking mental health care.
Proponents / Opponents Proponents: The bill has attracted unusually broad organizational support. Over 120 national healthcare associations have endorsed the reauthorization, including the American Hospital Association (AHA), the American Nurses Association (ANA), the American Academy of Nursing, the American Association of Critical-Care Nurses, the American Association of Colleges of Nursing, and the American College of Emergency Physicians, among many others (Dr. Lorna Breen Heroes’ Foundation, 2025). The bipartisan Problem Solvers Caucus formally endorsed the bill in early 2025, reflecting rare cross-party agreement on a healthcare workforce issue (Problem Solvers Caucus, 2025).

Supporters argue that the data compels action. Registered nurses currently experience a suicide rate of 16 per 100,000 person-years — higher than the general non-healthcare working population at 12.6 per 100,000 — and health care support workers face the highest rate of all healthcare occupations at 21.4 per 100,000 (Davidson et al., 2023). Approximately one in 18 nurses reported suicidal ideation in the past year in national survey data, and burnout has been independently identified as a predictor of suicidal thoughts in this population (Melnyk et al., 2025). Proponents also point to the program’s track record: since enactment in 2022, the original Lorna Breen Act has supported more than 250,000 health workers through 44 evidence-informed initiatives across hospitals, health systems, and educational institutions nationwide (Dr. Lorna Breen Heroes’ Foundation, 2025).

 

Opponents:

Organized opposition to the reauthorization is limited, which partly reflects the bill’s relatively modest fiscal footprint and its bipartisan framing. However, some fiscal conservatives have questioned whether a dedicated federal grant program is the appropriate mechanism for what might be considered an employer responsibility. The argument is that hospital systems and large healthcare organizations have the resources and operational incentive to address workforce wellness independently, and that federal grants may displace private investment rather than supplement it (Linzer et al., 2023).

A more substantive critique is that the bill does not address what many researchers identify as the structural drivers of burnout and mental health crisis — specifically, short staffing, excessive patient loads, and EHR-related administrative burden — and that peer-support programs and awareness campaigns, while valuable, are primarily downstream interventions that leave root causes intact. Critics in this camp do not oppose reauthorization per se but argue the bill’s scope is too narrow to meaningfully shift workforce mental health outcomes at a population level (Mohr et al., 2025).
Target Population The primary target population is the United States health care workforce — including registered nurses, physicians, physician assistants, advanced practice registered nurses, social workers, behavioral health professionals, pharmacists, and health care support workers. Of particular concern are frontline workers in high-acuity settings such as emergency departments, intensive care units, and inpatient medical-surgical units, who experience disproportionately high rates of burnout, depression, and suicidal ideation. The bill also targets health professions students, recognizing that burnout and mental health vulnerability often emerge during training.
Status of the Bill (Hearings / Committees?) H.R. 929 was referred to the House Committee on Energy and Commerce on February 4, 2025, and has not yet advanced to subcommittee hearings or a floor vote (Congress, 2025; LegiScan, 2025). The Senate companion bill, S. 266, was read twice and referred to the Senate Committee on Health, Education, Labor, and Pensions (HELP Committee) on January 28, 2025. As of early 2026, neither chamber has scheduled committee markups. GovTrack estimates a 12% probability of passage from committee and approximately a 5% probability of enactment — consistent with the overall low rate of bill enactment in recent congressional sessions (GovTrack, 2025).
General Notes / Comments The bill is notable for what it represents as much as what it does. It is, as far as federal legislation goes, one of the few bills explicitly dedicated to the mental health and wellbeing of the healthcare workforce rather than to patient care outcomes. Whether that framing helps or hinders its progress in a legislative environment focused primarily on healthcare costs and access remains to be seen. What is clear is that the problem the bill targets is real, measurable, and growing: nurse burnout rates, while slightly declining from their pandemic-era peaks, remain well above pre-2019 levels, and the connection between burnout, suicidal ideation, and patient safety errors is now well-established in the literature (Melnyk et al., 2025; Mohr et al., 2025). The outcome of the reauthorization effort — and, critically, whether Congress will fund the programs it authorizes — will matter considerably for a healthcare workforce still recovering from the cumulative effects of the COVID-19 pandemic.

Part 2: Legislation Testimony/Advocacy Statement

I support the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act of 2025 (H.R. 929 / S. 266), and I want to be direct about why. As a nurse, I have watched colleagues leave the profession quietly — not because they chose to, but because the mental and emotional weight of the work became more than they could carry without support. The bill before Congress is not a sweeping structural reform. What it does is more modest and, in its own way, more urgent: it keeps alive a federal program that has already demonstrated results, and it does so at a moment when health worker mental health cannot afford another legislative gap.

The original Dr. Lorna Breen Health Care Provider Protection Act was signed into law in 2022 following the death of Dr. Breen, an emergency physician who died by suicide in April 2020 after treating COVID-19 patients. Her story drew attention to something nurses and physicians had known for years: that the healthcare system creates conditions that put its own workers at serious mental health risk, and that licensing and credentialing barriers actively discourage those workers from seeking help. Since enactment, the program has supported more than 250,000 health workers through 44 evidence-informed initiatives across the country (Dr. Lorna Breen Heroes’ Foundation, 2025). The reauthorization bill extends this work through 2030. Without it, HRSA grant funding for peer support programs, mental health access initiatives, and burnout-reduction training would expire entirely.

The data supporting this bill is not ambiguous. Registered nurses face a suicide rate of 16 per 100,000 person-years, compared with 12.6 for non-healthcare workers, and health care support workers — often the least visible and least resourced members of the clinical team — face the highest rate of all at 21.4 per 100,000 (Davidson et al., 2023). Approximately one in 18 nurses reported suicidal ideation in the past year, and those individuals are statistically less likely to seek help than the general population (Melnyk et al., 2025). Burnout among nurses, though modestly declining from its 2022 peak of 60%, still affected 52% of the nursing workforce in 2023 — well above any reasonable baseline (Mayo Clinic Well-Being Index, 2024). These are not abstract workforce statistics. They represent real colleagues, in real units, making decisions about patient care while managing conditions that are going largely untreated.

I also support this bill because of what it does structurally, not only clinically. One of its key amendments expands HRSA grant eligibility to include organizations whose programs specifically address administrative burden — the documentation requirements, EHR inefficiencies, and bureaucratic tasks that 65% of nurses and 56% of physicians identify as primary contributors to burnout (AHA, 2024). This is a meaningful shift. Earlier versions of workforce wellbeing programs focused almost entirely on individual resilience — offering counseling resources and mindfulness workshops while leaving intact the system conditions that produce distress in the first place. Targeting administrative burden is an acknowledgment that the problem is partly organizational, not only personal.

Some will argue that this reauthorization is unnecessary — that large hospital systems are capable of funding peer support and mental health programs from their own operating budgets, and that federal grants may simply substitute for private investment that would have occurred anyway. That argument is worth taking seriously. What it overlooks, however, is that the organizations most in need of support are often the ones least able to fund these programs independently: rural and critical access hospitals, community health systems, federally qualified health centers, and health professions schools operating on tight margins. HRSA grants reach exactly these organizations (Congress, 2025). Removing federal funding does not cause well-resourced academic medical centers to cut their wellness programs — it leaves smaller institutions without the infrastructure to build them in the first place.

A separate criticism, which I find more substantive, is that peer support programs and awareness campaigns do not fix staffing shortages, EHR problems, or excessive patient loads. That is true. The bill does not fix those things, and it should not be evaluated as if it were designed to. What it does is provide a federally funded framework for organizations to support workers who are suffering now, while structural reforms remain contested. The two are not mutually exclusive. Nurses cannot wait for systemic change to access mental health care. Reauthorization of this program and broader workforce reform are both necessary; one does not substitute for the other.

Legislators considering this bill should understand that the consequences of inaction are not theoretical. The healthcare workforce is still recovering from the pandemic’s compressive effect on mental health, and the window for stabilizing that workforce is narrowing. The Lorna Breen Act’s programs represent some of the only federally funded infrastructure specifically designed to address this crisis at scale. I urge Congress to advance H.R. 929 and S. 266 through committee, bring both bills to a floor vote, and ensure that the programs they authorize are also adequately funded — because authorization without appropriation changes nothing for the nurses and health workers who need this support.

References

American Hospital Association. (2024). What physicians and nurses want execs to do about the burnout problem. AHA Center for Health Innovation Market Scan. https://www.aha.org/aha-center-health-innovation-market-scan/2024-02-06-what-physicians-and-nurses-want-execs-do-about-burnout-problem

Congress. (2025). H.R. 929 – Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, 119th Congress. https://www.congress.gov/bill/119th-congress/house-bill/929

Congress. (2025). S. 266 – Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, 119th Congress. https://www.congress.gov/bill/119th-congress/senate-bill/266

Davidson, J. E., Accardi, R., Sanchez, C., Zisook, S., & Mata, D. A. (2023). Nurse suicide: An updated analysis of rates and contributing factors from 2017–2021. Worldviews on Evidence-Based Nursing, 20(5), 389–396. https://doi.org/10.1111/wvn.12671

Dr. Lorna Breen Heroes’ Foundation. (2025). About the legislation: Dr. Lorna Breen Health Care Provider Protection Act. https://drlornabreen.org/about-the-legislation/

GovTrack. (2025). H.R. 929 (119th Congress): Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. https://www.govtrack.us/congress/bills/119/hr929

LegiScan. (2025). US HB929 – Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (2025). https://legiscan.com/US/bill/HB929/2025

Linzer, M., Jin, J. O., Shah, P., Stillman, M., Brown, R., Poplau, S., & Sinsky, C. A. (2023). Trends in clinician burnout with associated mitigating and aggravating factors during the COVID-19 pandemic. JAMA Health Forum, 4(7), e231809. https://doi.org/10.1001/jamahealthforum.2023.1809

Mayo Clinic Well-Being Index. (2024). 2023–2024 state of well-being report: Burnout trends among healthcare professions. Mayo Clinic Press. https://www.mayoclinicplatform.org/well-being-index/

Melnyk, B. M., Orsolini, L., Tan, A., Arslanian-Engoren, C., Melkus, G. D., Dunbar-Jacob, J., … & Lewis, L. M. (2025). Burnout, mental health, and workplace characteristics: Contributors and protective factors associated with suicidal ideation in high-risk nurses. Worldviews on Evidence-Based Nursing. Advance online publication. https://doi.org/10.1111/wvn.12803

Mohr, D. C., Awosika, A. O., & Wright, S. M. (2025). Burnout trends among US health care workers. JAMA Network Open, 8(4), e255960. https://doi.org/10.1001/jamanetworkopen.2025.5960

Problem Solvers Caucus. (2025, February). Problem Solvers Caucus endorses bill to expand mental health support for health care workers. https://problemsolverscaucus.house.gov/media/press-releases/problem-solvers-caucus-endorses-bill-to-expand-mental-health-support-for-health-care-workers

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