Congress Wants Medicare to Pay for Advanced Practice Nurse Training: What’s in the Bill

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A bipartisan group of nurse-allied lawmakers wants Medicare to start paying for the clinical training of the nation’s future nurse practitioners, nurse anesthetists, nurse-midwives, and clinical nurse specialists. The Educating Future Nurses Act (H.R. 10410), introduced in the House on September 16, 2026, would amend the Social Security Act to create a permanent national graduate nurse education program under Medicare.

The bill is led by Rep. Lauren Underwood (D-IL), a registered nurse, with cosponsors Rep. Jen Kiggans (R-VA), a geriatric nurse practitioner, and Rep. Suzanne Bonamici (D-OR). Underwood’s office announced the legislation on October 2, saying it has been endorsed by more than 30 nursing organizations, including the American Association of Colleges of Nursing (AACN) and the American Association of Nurse Anesthesiology (AANA).

If you have ever scrambled to find a preceptor or a clinical site for your NP or CRNA program, this bill is aimed squarely at that problem.

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Under the bill, Medicare would pay eligible hospitals, including critical access hospitals, for the costs of providing clinical education to advanced practice registered nurse (APRN) students. The program covers four APRN roles:

• Clinical nurse specialists (CNS)
• Nurse practitioners (NP)
• Certified registered nurse anesthetists (CRNA)
• Certified nurse-midwives (CNM)

The program is only for these APRN roles. It would not cover LPN, ADN, or BSN training.

Here is how the structure works, according to the legislation:

• Hospital partnerships: To qualify, a hospital must have written agreements with at least one school of nursing and at least two non-hospital, community-based care settings.
• Regional hubs: Hospitals would participate through regional Graduate Nurse Education Hubs, with only one hub allowed per region.
• Community-based training: At least half of the clinical education must take place outside the hospital, in settings such as federally qualified health centers, rural health clinics, nurse-managed clinics, schools, nursing homes, hospice programs, and home health agencies. That requirement can be waived for hospitals in rural or medically underserved areas.
• Per-student payments: Hospitals would receive a per-student rate based on data from the earlier Graduate Nurse Education Demonstration, adjusted over time for changes in the Consumer Price Index, multiplied by the number of APRN students trained.
• Growth only: Payments cover only the costs of training APRN students above a school’s 2024-2025 baseline, so the funding is aimed at adding capacity, not covering existing programs.
• Accountability: Hospitals must report annually on program activities and where graduates end up working. Those that fail to report would see their payments cut by 25 percent.

Funding would be transferred from the Medicare trust funds to the Centers for Medicare & Medicaid Services. The bill does not set a specific dollar figure, and it requires the Secretary of Health and Human Services to send Congress a report on the program within two years of enactment.

Medicare has long helped fund residency training for physicians, but when Underwood introduced a version of this bill in 2023, she noted that “there is currently no federal funding stream that invests in graduate nursing education.”

That gap shows up in admissions data. According to AACN’s 2025-2026 enrollment survey, nursing schools turned away 93,176 qualified applications in 2025, including 6,496 from master’s programs and 9,859 from DNP programs. AACN cites the main barriers as:

• Insufficient clinical placement sites
• Lack of qualified faculty and preceptors
• Classroom space
• Budget cuts

The new bill builds on a model that has already been tested. The Affordable Care Act created the Graduate Nurse Education Demonstration, which reimbursed five hospitals for APRN clinical training costs. CMS’s final evaluation found that APRN student enrollment and graduations at participating schools rose by 54% and 67%, respectively, on average compared with pre-demonstration levels.

“In every corner of our country, nurses are doing critical work to support the health and well-being of our communities,” Underwood said in the October announcement. “But our profession is under unprecedented attack, particularly for nurses who are looking to further their education,” she added. “America needs more nurses, not fewer.”

Kiggans referenced her own clinical background. “As a geriatric nurse practitioner and Congressional Nursing Caucus co-chair, I know that a strong nursing workforce starts with ensuring our future nurses have the training and resources they need to effectively care for their patients,” she said. “Unfortunately, there are too many aspiring advanced practice nurses who face barriers from accessing the education required to complete their training.”

Bonamici added that “our country is in desperate need of more nurses, including advanced practice nurses, but there are too many barriers to graduate education.”

AACN President and CEO Dr. Deborah Trautman said that “by building on the success of the Graduate Nurse Education demonstration program, the Educating Future Nurses Act will have a profound impact on sustaining the nation’s Advanced Practice Registered Nursing workforce and access to care for all patients in need.”

The bill arrives as graduate nursing students face other financial pressures. In April 2026, the Education Department finalized a rule that excludes MSN, DNP, and nursing PhD programs from its definition of “professional” degrees, despite a bipartisan letter led by Kiggans, Bonamici, and Sens. Jeff Merkley and Roger Wicker opposing it. Since July 1, 2026, new borrowers in those programs have been capped at $20,500 a year and $100,000 total in federal loans, compared with $50,000 a year and $200,000 for professional programs.

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This bill is not law yet. H.R. 10410 has been referred to the House Committee on Ways and Means and the Committee on Energy and Commerce, and it would need to clear committee and pass both the House and Senate before reaching the president’s desk. The 2023 version was introduced in both chambers but was not enacted.

Still, here is why it matters for you:

• If you are an RN thinking about NP, CRNA, CNM, or CNS school: Finding clinical placements and preceptors is one of the biggest bottlenecks in graduate nursing education. A dedicated Medicare funding stream could give hospitals a financial reason to take on more APRN students.
• If you precept or work in community settings: The requirement that at least half of training happen outside the hospital could bring more APRN students into clinics, nursing homes, schools, and home health agencies.
• If you work in rural or underserved areas: Lawmakers say the funding would help hospitals train APRNs in geographically diverse areas, especially rural and underserved communities, where access to primary, anesthesia, and maternity care is often thin.
• If you want to weigh in: Bills with bipartisan sponsors and broad professional backing have a better shot, but they still need public support. Contacting your representative or following your professional organization’s advocacy alerts is the most direct way to have a say.

🤔 Did finding a clinical site or preceptor slow down your APRN program, and would hospital funding like this have made a difference? Share your experience in the comments.