More than 200 nurses, nursing students, and advanced practice registered nurses gathered at the Tennessee State Capitol on Feb. 11 as the Tennessee Nurses Association launched its annual Nurses Day on the Hill — the organization’s primary push to place nursing priorities in front of the 114th General Assembly before the session reached its most active phase. Three months later, the legislature has adjourned, and the outcome is a mixed picture for the profession.
The day opened with morning education sessions and continuing nursing education credit programming at Tennessee State University’s Avon Williams Campus in Nashville, followed by scheduled one-on-one and small-group meetings between nursing attendees and their district representatives and senators at the Capitol. Participants came from hospitals, clinical practices, and nursing schools across the state, with many students attending a legislative summit for the first time.
Two issues drove most conversations that afternoon.
First, APRN scope-of-practice protections. In the previous session, proposed restrictions on advanced practice nursing had triggered a rapid-response campaign in which TNA members sent more than 6,000 messages to legislators within 24 hours explaining how damaging the restrictions would be to nurses and patients across Tennessee. Those restrictions were ultimately blocked, but the underlying legislative pressure has not disappeared, making direct contact with lawmakers — before bills advance through committee — a core objective of February’s summit.
Second, nursing education funding. A federal reclassification set to take effect July 1, 2026, would limit graduate nursing student loans to $100,000 — a cap nursing organizations say would reduce enrollment capacity and weaken the long-term workforce pipeline at a moment when Tennessee already faces provider shortages, particularly in rural counties.
“We need a workforce that looks like the state of Tennessee, and we need patients to know that they can trust their caregiver because that caregiver has been in their shoes,” said Ray Coe, PhD, RN-BC, NEA-BC, past president of TNA, who has been central to the organization’s workforce equity efforts.
The 114th General Assembly adjourned sine die on April 23 after a session marked by significant healthcare policy shifts. On the positive side for healthcare access, legislation passed that removes Certificate of Need requirements for several key services, including acute care hospitals and satellite emergency departments, a change supporters argue will expand access in underserved areas. The $58.3 billion budget included $205 million for healthcare initiatives.
More directly relevant to nursing practice, however, a broad coalition of healthcare providers saw multiple bills targeting health insurance reform — including measures on prior authorization timelines, fair claims processing, and network adequacy — fail to advance far enough to be enacted, though lawmakers signaled many of those proposals are likely to return.
For nurses at the bedside, prior authorization delays represent one of the most tangible daily obstacles to delivering timely patient care — a point TNA members raised with legislators throughout the session.
The 115th General Assembly will not convene until January 12, 2027. TNA has indicated it will use the interim to continue building legislative relationships and tracking the rollout of the federal graduate loan cap, which takes effect this July and is expected to affect nursing school enrollment figures across the state as early as the fall semester.