HEALTH PROFESSIONS
REGULATORY ISSUES Department of State Government Relations and the
Department of Political and Grassroots Programs
Health care delivery in the United States is being transformed from a fee for service, illness- based model to a capitated model with an emphasis on efficiency, cost cutting and wellness. The transition between the two models is causing reverberations throughout the entire health care system as consumers, providers, and purchasers of health care are watching and influencing new ways of doing business. Both state and federal legislators and some constituents are grappling with how to ensure the resulting model is one that will adequately meet the needs of consumers as well as provide quality care.
Following the failure of the broad-based Clinton Health Care Reform proposal and subsequent comprehensive state health care reform measures, economic forces have been pushing market-based reforms. United States businesses are positioning themselves to be greater competitors in the global economy and thus are demanding lower priced health care premiums. In addition, attempts by Congress to balance the federal budget and control health care spending have resulted in tightening of payments to the Medicare and Medicaid programs.
Managed care is seen by many as the magic answer to controlling health care costs. Membership in managed care plans has been growing rapidly in both the private and public arena. Increasingly, states are seeking Medicaid Waivers that allow enrollment of the Medicaid population in managed care plans.
As market-based changes continue, the central role of government becomes more important in stabilizing the interests and welfare of the public against those of business and providers. Legislators are attempting to balance the need to control health care costs while protecting consumers from abuses in the delivery system that limit access to the quality care they need. It is in the midst of this balancing act that public policy changes affecting nurses and nursing practice occur. State governments are attempting to make changes in nurse practice acts to expand nursing delegation in non-institutional long term care settings. Some state governments are reorganizing the board of nursing and revamping licensure systems. And many state legislators are pushing legislation to protect patient rights. As a result, the introduction of legislation in statehouses across the country has exploded in an attempt to address issues surrounding the new evolving model of health care.
This report provides an overview of state and federal legislative activities related to critical issues facing nurses and nursing practice. It highlights both legislative and regulatory efforts to reform health professions regulation, expand scope of practice, develop telehealth networks, regulate managed care organizations and protect patients. More important, this report highlights the major legislative initiatives advanced by SNAs. Great strides have been made in each of these critical areas due to the diligent efforts of ANA and SNA members.
This report was compiled with information provided by State Nurses Associations and the Health Policy Tracking Service Foundation for State Legislatures, an affiliate of the National Conference of State Legislatures. This document is a working report and will continue to be modified and updated on a regular basis. Please forward any comments, corrections or modifications to Terri Gaffney, MPA, RN, Director, Department of State Government Relations, American Nurses Association.
HEALTH PROFESSIONS
REGULATORY ISSUESUNLICENSED
ASSISTIVE PERSONNELPATIENT SAFETY
INITIATIVESTELEHEALTH
LEGISLATIONMANAGED
CARE FOR-PROFIT
CONVERSIONS OF NONPROFIT HOSPITALS
Return to the Legislative Branch.
 |