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ANA's Letter to President-Elect Trump

December 5, 2016

Donald J. Trump
1717 Pennsylvania Avenue
Washington, DC 20006

Dear President-Elect Trump:

America’s 3.6 million registered nurses (RNs) care profoundly about the health and welfare of our nation. Nurses provide expert, compassionate care for people throughout their life and work in every health care setting. As the largest group of health care professionals and the nation’s most trusted profession, nurses are a valuable resource for improving the nation’s health care delivery system.

For decades, the American Nurses Association (ANA) has advocated for health care system reforms that would guarantee access to high-quality, affordable health care for all. ANA is calling on you and your administration to prioritize the health of the nation, which is foundational to progress and economic growth. We are pleased to share our principles for health system transformation.

ANA’s Principles for Health System Transformation

The system must:

Ensure universal access to a standard package of essential health care services for all citizens and residents. This includes:

  • An essential benefits package that provides access to comprehensive services, including mental health services.
  • Prohibition of the denial of coverage because of a pre-existing condition.
  • Inclusion of children on parent’s health insurance coverage until age 26.
  • Expansion of Medicaid as a safety net for the most vulnerable, including the chronically ill, elderly and poor.

Optimize primary, community-based and preventive services while supporting the cost-effective use of innovative, technology-driven, acute, hospital-based services. This includes:

  • Primary health care that is focused on developing an engaged partnership with the patient.
  • Primary health care that includes preventive, curative, and rehabilitative services delivered in a coordinated manner by members of the health care team.
  • Removing barriers and restrictions that prevent RNs and Advanced Practice Registered Nurses (APRNs) from contributing fully to patient care in all communities.
  • Care coordination services that reduce costs and improve outcomes with consistent payment for all qualified health professionals delivering such services, including nurses.

Encourage mechanisms to stimulate economical use of health care services while supporting those who do not have the means to share in costs. This includes:

  • A partnership between the government and private sector to bear health care costs.
  • Payment systems that reward quality and the appropriate, effective use of resources.
  • Beneficiaries paying for a portion of their care to provide an incentive for the efficient use of services while ensuring that deductibles and co-payments are not a barrier to receiving care.
  • Elimination of lifetime caps or annual limits on coverage.
  • Federal subsidies based on an income-based sliding scale to assist individuals to purchase insurance coverage.

Ensure a sufficient supply of a skilled workforce dedicated to providing high quality health care services. This includes:

  • An adequate supply of well-educated, well-distributed, and well-utilized registered nurses.
  • Increased funding, whether grant or loan repayment based, for programs and services focused on increasing the primary care workforce.
  • Funding to elevate support for increasing nursing faculty and workforce diversity.

ANA looks forward to working with you and your administration to address our nation’s health care challenges. We look forward to sharing the expertise of nurses throughout your transition period and presidency to improve the health care system and the health of the nation. Should you or your staff have any questions, please contact me or Michelle Artz, Director, Government Affairs ( or 301-628-5098).

Yours in partnership,

Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN

Cc: Andrew Bremberg

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The American Nurses Foundation is a separate charitable organization under Section 501(c)(3) of the Internal Revenue Code. The Foundation does not engage in political campaign activities or communications.

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