Why It Matters
The National Association of Clinical Nurse Specialists’ return to federal lobbying after six years signals an intent to capitalize on unprecedented congressional momentum around nursing workforce issues. With bipartisan backing for the I CAN Act and the Title VIII Nursing Workforce Reauthorization Act of 2025—both directly aligned with NACNS priorities—the organization is well-positioned to influence federal reimbursement and scope of practice authority.
By hiring Federal Group Inc. and veteran healthcare lobbyist Patrick J. Cooney, NACNS has enhanced its advocacy capacity after operating through KAR Associates LLC from 2013 to 2018.
By the Numbers
NACNS actively lobbied from 2013 to 2018, filing 22 disclosures before a six-year hiatus. The organization retained Federal Group Inc. as its new lobbying firm effective January 1, 2025. Patrick J. Cooney brings over two decades of healthcare policy lobbying experience, with client history including the American College of Nurse-Midwives and American Physical Therapy Association. Federal Group Inc. has filed over 800 lobbying disclosures over two decades with a client portfolio concentrated on healthcare professional associations.
The Agenda
NACNS is lobbying primarily on healthcare delivery, Medicare, and Medicaid issues. The organization’s re-engagement aligns with two key legislative vehicles: the Improving Care and Access to Nurses (I CAN) Act, which would remove federal barriers preventing APRNs from practicing to the full extent of their state licensure, and the Title VIII Nursing Workforce Reauthorization Act of 2025, which would expand grant eligibility to include clinical nurse specialist programs and increase annual funding from $137.8 million to $184.3 million.
Broader Context
There is an acute nursing workforce crisis. The U.S. faces a projected shortage of over 500,000 registered nurses by 2030, with more than 193,000 nursing positions opening annually. Over 91,000 qualified nursing applicants were turned away from programs in 2021 due to faculty and clinical placement shortages.
Still, there are headwinds. Over 150 bills expanding non-physician practitioner authority were defeated across states in 2025, with physician groups framing such changes as "scope creep." Title VIII funding faces budgetary pressure despite legislative support, with the House Appropriations Committee voting to cut nursing programs while the Senate advanced level funding.
Between The Lines
The House Energy and Commerce Committee’s Health Subcommittee has held multiple hearings emphasizing that Title VII and Title VIII programs are "crucial for supporting the medical workforce." Rep. Chris Pappas has highlighted APRN care safety data, while Reps. Zach Nunn, Dina Titus, and Susie Lee introduced the Train More Nurses Act to address educational bottlenecks.
Competitive Landscape
NACNS enters a crowded advocacy space where the American Nurses Association, American Association of Nurse Anesthesiology, and American Association of Colleges of Nursing are already heavily engaged on the same legislative priorities. NACNS must differentiate its message around clinical nurse specialists within broader APRN advocacy efforts.
The Bottom Line
NACNS is capitalizing on strong bipartisan congressional momentum around nursing workforce expansion, particularly the I CAN Act and Title VIII Nursing Workforce Reauthorization Act. However, the organization enters a contested landscape where physician opposition to scope expansions remains significant and federal funding faces budget pressures despite legislative support.
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