July 21, 2022

House Advances Nursing Education Funding

With the September 30 end of the 2022 fiscal year rapidly approaching, Congress is ramping up efforts to pass appropriations for federal programs for fiscal 2023, including money for nursing education and workforce development programs. The House is expected to vote next week on a package of measures that includes funding for the Department of Health and Human Services and provides a $44 million increase for nursing programs under Title VIII of the Public Health Service Act and almost $28 million more for nursing research. The added funding for Title VIII programs includes $20 million targeted to increase and diversify the number of certified nurse midwives, especially in rural and underserved communities, while much of the higher spending for the National Institute of Nursing Research would support research related to identifying and reducing health disparities.

In spite of the House action, a final agreement on fiscal 2023 funding appears unlikely until after the November midterm election. Senate appropriators have yet to release their version of the spending plans and don’t intend to vote on them separately, but rather use them in negotiations with the House on a final agreement. As a result, lawmakers are expected to pass a continuing resolution in September that will extend fiscal 2022 funding levels until a post-election “lame duck” session including an omnibus appropriations deal.

Senate Democrats Seek to Revive Budget Bill
 
A year after President Biden originally proposed his ambitious domestic spending plan, Senate Democrats are making another attempt to resurrect a much smaller version of the proposal. Democratic Senator Joe Manchin of West Virginia, whose opposition in an evenly divided Senate effectively killed the House-passed “Build Back Better Act” (H.R. 5376) last December, indicated last week that he would support a package of measures to lower prescription drug prices and extend higher subsidies to help individuals and families buy health coverage. That proposal would use Senate budget rules to allow Democrats to prevent a Republican filibuster and pass the bill without their support – as long as all 50 Democrats support it.

After reiterating his concerns about rising inflation and federal deficits, Manchin said he would back a plan to allow Medicare to negotiate the price of some prescription drugs and use part of the savings from that policy to pay for extending enhanced subsidies to help consumers pay the premiums for health coverage sold on Affordable Care Act marketplaces. Congress approved the higher subsidies last year as part of the “American Rescue Plan Act,” sparking record high enrollment in marketplace coverage.

Advocates are scrambling to see if additional health care priorities from the “Build Back Better Act” could be included in the revised bill, including full-year Medicaid postpartum coverage, expanded home and community-based services, and continuous coverage for children. The NLN is also working with other nursing organizations to push for inclusion of increased resources for nursing education infrastructure.

Administration Proposes to Ease Student Loan Discharges
 
The Biden administration recently proposed major changes to the federal student loan system, including measures that help discharge loans for physically and mentally disabled borrowers, limit interest capitalization rates, and help borrowers working as public service employees to earn forgiveness on their loans. The Department of Education is seeking to make it easier for borrowers to file and pursue claims of predatory practices by colleges and help students who enrolled in schools 180 days prior to a school closure and who didn’t complete their education to discharge the loans more easily.

The plan includes changes to Public Service Loan Forgiveness (PSLF), which grants loan forgiveness for those serving full time in certain public service positions, allowing more payments to qualify for the program, including partial, lump-sum, and late payments. It also would allow some deferments and forbearances to count toward PSLF and create a formal reconsideration process for applicants who were denied access to the program. Other proposals include eliminating interest capitalization rates on loans for borrowers in certain instances, making it easier for permanently disabled borrowers to qualify for loan forgiveness, and giving borrowers an easier path toward loan forgiveness if they were falsely certified and ineligible for a loan.