Thursday, July 20, 2023

Washington, D.C. – Oregon’s U.S. Senator Jeff Merkley and Wyoming’s U.S. Senator Cynthia Lummis teamed up to introduce the Improving Care and Access to Nurses (I CAN) Act, bipartisan legislation that would remove federal barriers to practice in federal health programs for Advanced Practice Registered Nurses (APRNs). This legislation is a pathway to increasing patient choice, lowering health care costs, and empowering nurses and patients alike.

“As the husband of a nurse, I know just how valuable and critical care provided by nurses is and the impact they have on their patients,” said Senator Merkley. “Removing these barriers will increase patients’ access to highly-trained nurses, reduce costs, and improve care for patients.”

“The federal government should not stand in the way of people in Wyoming getting high quality health care,” said Senator Lummis. “Allowing advanced practice registered nurses to treat more patients will help lower costs and expand health care access in underserved rural communities throughout Wyoming.”

Advanced practice registered nurses (APRNs) are prepared at the masters or doctoral level to provide primary, acute, chronic, and specialty care to patients of all ages and backgrounds, and in all settings. APRNs include nurse practitioners, nurse anesthetists, nurse-midwives, and clinical nurse specialists, and all play a pivotal role in the future of health care. Currently, there are federal barriers and institutional rules that limit APRN practice and prevent APRNs from providing the full scope of the health care services they have been trained to provide. These laws and regulations reduce patients’ access to services—particularly in underserved areas—and disrupt continuity of care, increase costs in our health system, and undermine efforts to improve the quality of health care.

The I CAN Act would increase access, improve quality of care, and lower costs in the Medicare and Medicaid programs by removing barriers to practice for APRNs, consistent with National Academy of Medicine (NAM) recommendations.

Companion legislation was introduced earlier this year in the House by Representatives Dave Joyce (R-OH-14), Suzanne Bonamici (D-OR-01), Jennifer Kiggans (R-VA-02), and Lauren Underwood (D-IL-14).

The I CAN Act is endorsed by the American Nurses Association (ANA), American Association of Nurse Anesthesiology (AANA), American Association of Nurse Practitioners (AANP), and the American College of Nurse-Midwives (ACNM). Over 200 health care organizations, including the Oregon Nurses Association (ONA) and the Oregon Association of Nurse Anesthetists (ORANA), have urged Congress to support this legislation.

“I am in full support of the senate companion to the I CAN Act that is being introduced with considerable bipartisan support. APRNs serve millions of patients and communities, helping to ensure quality and equitable patient-centered care and allowing patients more decision-making power in choosing the provider of their choice. ANA will continue to push every legislative lever that removes antiquated barriers in nursing so that APRNs are enabled to practice at the top of their education and clinical training critical. I want to send a special thank you to Sen. Merkley and Sen. Lummis for leading these efforts in the Senate as well as Rep. Joyce, Rep. Bonamici, Rep. Underwood, and Rep. Kiggans for introducing this bill in the House and for their continued commitment to the nursing profession and patient care,” said ANA President Jennifer Mensik Kennedy, PhD, MBA, RN, NEA-BC, FAAN.

“AANA thanks Senators Merkley and Lummis for introducing the I CAN Act in the Senate. As the only anesthesia provider in most rural hospitals and the predominant provider in underserved communities, Certified Registered Nurse Anesthetists (CRNAs) play an important role in ensuring patients receive quality anesthesia care where and when it is needed most. CRNAs serve on the frontlines of healthcare from the armed services to local communities and reducing unnecessary barriers to that care is critical.  We applaud their leadership and action to reduce barriers to healthcare and address the critical workforce shortages facing many healthcare facilities. This critical legislation will help ensure that everyone who needs access to the high-quality care Advance Practice Registered Nurses such as CRNAs provide, can have it,” said AANA President Angela Mund, DNP, CRNA.

“The American Association of Nurse Practitioners (AANP) thanks Senators Merkley and Lummis for introducing the I CAN Act in the U.S. Senate. This important legislation will modernize the Medicare and Medicaid programs to more accurately reflect our nation’s health care workforce by removing outdated federal barriers that currently limit patient access to timely, high-quality health care from their chosen provider. Today, millions of patients choose nurse practitioners as their health care provider, and this legislation will help ensure they have equitable access to the care they deserve,” said AANP President Stephen Ferrara, DNP, FNP-BC, FAANP, FAAN.

“The American College of Nurse-Midwives thanks Senator Merkley and Senator Lummis for their support of our nation’s advanced practice registered nurses (APRNs). Decades of research and numerous studies has shown that better integration of midwives and nurses practicing to the full extent of their education, clinical training, and certification within a team-based care model throughout our nation’s health care system can help prevent maternal deaths, reduce racial disparities, reduce primary cesarean sections, improve maternal and neonatal outcomes, and improve access to health care for all. We applaud the Senate’s bipartisan introduction of the Improving Care and Access to Nurses Act, critical legislation that recognizes the distinct roles that midwives and APRNs play in providing high-quality health care throughout the lifespan,” said ACNM Interim CEO, Michelle L. Munroe, DNP, CNM, FACNM, FAAN.

“Workforce shortages throughout the long-term care sector have already strained older adults’ and families’ access to critical services and supports—and demand will only grow as America’s population rapidly ages. By expanding the scope of practice for Advanced Practice Registered Nurses (APRNs) in hospice, skilled nursing and other critical areas, the Improving Care and Access to Nurses (I CAN) Act removes current barriers that inhibit the efficient use of the valuable APRN workforce and expands APRNs’ impact, which will improve older adults’ and families’ ability to get the care they need. We thank Senators Merkley and Lummis for their commitment to this important legislation as the bipartisan companion of the House I CAN Act. Solving the aging services workforce crisis requires action on all fronts; this bill’s introduction brings us one step closer to achieving our goals,” said Katie Smith Sloan, president and CEO, LeadingAge, the association of nonprofit providers of aging services.

“ORANA thanks Senators Merkley, Lummis for introducing the Improving Care and Access to Nurses legislation. As the only anesthesia provider in most rural hospitals, and the predominant provider in underserved communities, Certified Registered Nurse Anesthetists (CRNAs) play an important role in maintaining critical access in communities across the country. Removing unnecessary regulations that currently pose barriers to expanding care is especially imperative at a time when many rural communities do not have enough anesthesia providers. This critical legislation is an answer to workforce shortages in healthcare. It will reduce barriers to help ensure that patients can receive access to safe, high-quality care Advance Practice Registered Nurses such as CRNAs provide,” said ORANA President Andrea Hargis, DNP, CRNA.

“The Improving Care and Access to Nurses Act (I CAN Act) will have a dramatic and immediate impact on the lives of Oregonians, and all Americans, by allowing a wide range of advanced practice nurses (APRNs) to work at the fullest extent of their skills and abilities,” said Rachel Prusak, MSN, FNP-BC, APRN, Chair of the Nurse Practitioners of Oregon (NPO). “For too long, administrative red tape and legislative barriers have prevented nurse practitioners and other APRNs from meeting the full needs of their patients. With the I CAN Act, those barriers will be removed, and patients and providers will both benefit. Oregon’s APRNs fully support the I CAN Act, and we are deeply grateful to Senator Merkley and colleagues for introducing this transformative bill.”

“The I CAN Act, which is supported by both Democrats and Republicans, allows for qualified professionals to provide full spectrum healthcare at the top of their training and education and corrects outdated and arbitrary legislation, to allow for increased and equitable access to well-being and health across the United States.” said Laurel Hallock-Koppelman, DNP, FNP-BS, APRN, FAANP, NPO member and AANP fellow. 

Bill text can be found here.

A bill summary can be found here