Assignment legislation comparison grid and advocacy statement

Assignment legislation comparison grid and advocacy statement

Assignment legislation comparison grid and advocacy statement

Maternal healthcare is one of the determinants of the quality, safety and efficiency of health in a state. The US is one of the most developed countries in the world. It is therefore expected to have the lowest maternal mortality and morbidity rates in the world. However, statistics show that the rates of maternal mortality and morbidity in the US are significantly high. Consequently, this paper explores a proposed policy that aims at reducing the current rates and trends in maternal mortality and morbidity in the USA.

Health-related Bill NameRecognizing The Maternal Health Crisis In The United States And The Importance Of Reducing Mortality And Morbidity Among All Women And Honoring Mothers
Bill NumberH.Res.539
DescriptionMaternal mortality and morbidity is a critical issue affecting the United States of America. The statistics presented in the bill shows that despite being a developed nation, America has the highest rate of maternal mortality and morbidity. The statistics also show that the risk for maternal mortality and morbidity is significantly elevated among women from ethnic minority groups when compared to the American natives. Women also experience challenges in their maternal care such as mistreatment that degrade their self-identity and autonomy. Based on the above maternal health-related issues, the Recognizing The Maternal Health Crisis In The United States And The Importance Of Reducing Mortality And Morbidity Among All Women And Honoring Mothers Act was proposed for implementation. The act seeks to address the issue by focusing on a number of aspects related to maternal health. Firstly, it seeks to raise the awareness of the public about maternal morbidity, mortality and the existence of disparities in maternal health-related outcomes. The bill also seeks to encourage states, Federal Government, territories, local communications and healthcare organizations among other stakeholders to take interventions that reduce the risk and rate of adverse maternal health outcomes as well as improve maternal safety. The other aims of the act include addressing and eliminating disparities in maternal health outcomes, ensuring the provision of equitable and respectively maternal care, honoring mothers who have died due to pregnancy-related complications, and supporting the collection of data on maternal morbidity and mortality. It also supports the need for further investment efforts to enhance maternal health and health outcomes as well as eliminate disparities in maternal healthcare.      
Federal or State?Federal
Legislative IntentThe legislative intent of the act is to recognize the seriousness of maternal morbidity and mortality issues in the US. The act also seeks to raise the awareness of the public and other stakeholders on the need to prevent maternal morbidity and mortality. Further, the act aims at ensuring the disparities in outcomes of maternal health are eliminated. Lastly, it aims at ensuring that mothers and pregnant women receive respectful care that meets their health needs.
Proponents/ OpponentsProponents: They include Reps. Underwood Lauren, Kelly Robin, Spanberger Abigail Davis, Wexton Jennifer, and Adams Alma.    
Opponents: none    
Target PopulationThe primary beneficiaries of the proposed bill are pregnant women and mothers. It also includes women from ethnic minorities. The secondary target population includes healthcare providers, policymakers, and communities.  
Status of the bill (Is it in hearings or committees?)The bill has been referred to the House Committee on Energy and Commerce.      
General Notes/CommentsThe proposed bill is a crucial bill that should be adopted in the US. The need for the bill is attributed to the high rate of maternal mortality and morbidity rates in the USA. Its implementation would therefore support the provision of care that addresses the needs of pregnant women and mothers from diverse ethnic backgrounds.

Advocacy Statement

            Maternal mortality and morbidity is a critical issue in the US despite it being a developed nation (Collier & Molina, 2019; Joseph et al., 2021). For example, statistics show that 60% of the maternal mortalities reported in the US are preventable. In addition, the risk of women of ethnic minority groups such as African American and American Indians dying from pregnancy related complications is three times that of the White women. Women also experience different forms of mistreatment, as they receive their needed maternal healthcare (Morton et al., 2019). Therefore, the proposed bill should be adopted in the USA to address the identified issues. The bill will increase the maternal health outcomes as well as the quality of care mothers and pregnant women receive (, 2021). Through the bill, the USA will rank among the world’s leading nations with lowest maternal mortality and morbidity rates. I will address the opponents in my position by presenting facts above the severity of the issue of maternal mortalities and morbidities in the US. I will also provide the socioeconomic implications of maternal mortalities and morbidities to the state. For example, I will explore the cost implications of the issue to the American economy and families.


            The US currently has a high rate of maternal mortality and morbidity. Significant disparities exist in maternal health outcomes due to ethnicity of the mothers and pregnant women. The proposed bill is important in ensuring equity in maternal healthcare and adoption of best practices to reduce and prevent maternal mortalities and morbidities. Therefore, it should be implemented to promote public health.

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Collier, A. Y., & Molina, R. L. (2019). Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions. NeoReviews, 20(10), e561–e574.

Morton, C. H., VanOtterloo, L. R., Seacrist, M. J., & Main, E. K. (2019). Translating Maternal Mortality Review Into Quality Improvement Opportunities in Response to Pregnancy-Related Deaths in California. Journal of Obstetric, Gynecologic & Neonatal Nursing, 48(3), 252–262.

Joseph, K. S., Boutin, A., Lisonkova, S., Muraca, G. M., Razaz, N., John, S., … & Schisterman, E. (2021). Maternal Mortality in the United States: Recent Trends, Current Status, and Future Considerations. Obstetrics and Gynecology, 137(5), 763. doi: 10.1097/AOG.0000000000004361 (2021, July 19). Text – H.Res.539 – 117th Congress (2021-2022): Recognizing the maternal health crisis in the United States and the importance of reducing mortality and morbidity among all women, and honoring mothers. (2021/2022) [Legislation].

As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.

Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.

To Prepare:

Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.
The Assignment: (1- to 2-page Comparison Grid; 1- to 2-page Legislation Testimony/Advocacy Statement)

Part 1: Legislation Comparison Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:

Determine the legislative intent of the bill you have reviewed.
Identify the proponents/opponents of the bill.

NURS 6050 Week 4 assignment: Legislation Comparison Grid and Testimony/Advocacy Statement Example
Identify the target populations addressed by the bill.
Where in the process is the bill currently? Is it in hearings or committees?
Is it receiving press coverage?

Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1- to 2-page Legislation Testimony/Advocacy Statement that addresses the following:

Advocate a position for the bill you selected and write testimony in support of your position.
Describe how you would address the opponent to your position. Be specific and provide examples.
Recommend at least one amendment to the bill in support of your position.

Legislation comparison and advocacy

Part 1. Legislative comparison grid

Health-related Bill nameAutism CARES Act of 2019 (Autism collaboration, accountability, research, education, and support Act of 2019)
DescriptionThe Bill has been presented as a legislative requirement to reauthorize the Autism CARES Act by 30th September 2019. Its legislative history dates back to 2006 when President George W. Bush signed it into law as Combating Autism Act (P.L. 109-416). The intention of the law was to offer coordinated federal response to the dramatic increase in persons diagnosed with autism spectrum disorder in the country. It increased public investment to address the growing needs of persons diagnosed with autism spectrum of disorders, while authorizing the Interagency Autism Coordinating Committee to coordinate federal efforts targeted at the disorder. The legislation was reauthorized in 2014 as the Autism CARES Act (P.L. 113-157). It must be reauthorized by September 2019 for the Federal activities conducted under the legislation to continue (Autism Society, 2019).
Federal or State?Federal
Legislative intentThe Bill was introduced into the House of Representatives as House Bill (H.R. 1058) by Rep. Chris Smith (R-NJ) and Rep. Mike Doyle. The Bill was introduced into Senate as Senate Bill (S. 427) by Senator Bob Menendez (D-NJ_ and Senator Mike Enzi (R-WY).Legislative discussions are still ongoing for the Bill with proposals to expand and intensify the current format of the legislation. The intention is to enhance the activities of the National Institutes of Health with a focus on the Public Health Service Act (42 U.S.C. 284g) to support research on autism spectrum disorders, and reduce care gaps (Autism Society, 2019). NURS 6050 Week 4 assignment: Legislation Comparison Grid and Testimony/Advocacy Statement Example
Target populationThe target population is persons diagnosed with autism spectrum disorder. The intention is to improve their care quality and outcomes through supporting research activities that improve understanding of the disorder.
Status of the bill (is it in hearings or committees? Is it receiving press coverage?)The Bill was introduced in the 1st session of the 116th Congress and discussions are currently ongoing with focus on amending the Public Health Service Act to enhance the activities of the National Institutes of Health with the intention of supporting research activities on autism spectrum disorder and enhancing health care programs.It was introduced to the Senate by Mr. Menendez and Mr. Enzi, read twice and referred to the health committee.The Bill is receiving press coverage with legislators brining public attention to its content and intentions. Rep. Mike Doyle (D-PA), Rep. Chris Smith (R-NJ), Senator Mike Enzi (R- WY), and Senator Bob Menedez (D- NJ) made press releases to drum up public support for the Bill. In April 2019, Congressman Smith wrote a letter to support full funding for the Bill. In addition, other organizations that focus on improving autism care are brining attention to the Bill. In May 2019, 35 national organizations wrote a coalition in support of the Bill. An updated letter was written later in the same month to ask for expedited consideration of the Bill (Autism Society, 2019).
General notes/commentsThe Bill seeks to provide comprehensive attention to the care of persons with autism spectrum disorder. Still, there is a concern that the deadline for reauthorizing the Bill is 30th September 2019 and yet legislative debate is still ongoing to imply that the Bill may not be reauthorized by 30th September.Should the Bill be reauthorized in its current form, there substantive advances will be realized in the care of persons with autism spectrum disorders. It would improve infrastructure and surveillance, inform on lifespan issues, identify helpful treatments and interventions, identify risk factors, inform on the biology, and determining diagnosis and screening concerns NURS 6050 Week 4 assignment: Legislation Comparison Grid and Testimony/Advocacy Statement Example.Overall, the Bill seeks to make substantive improvements in the care of persons with autism spectrum disorders, and these benefits can only be realized if the Bill is reauthorized before the 30th September deadline (Autism Society, 2019).

Regardless of geographical location, race, culture, and other factors, all populations deserve quality, timely, and affordable health. Besides, health care providers and stakeholders should devise interventions for health promotion and the protection of vulnerable communities. Health care policies are instrumental in health promotion since they outline guidelines for benefitting patients, communities, and health care providers (Wolstenholme & McKelvie, 2019). As a result, Congress and other law-making bodies formulate health promotion bills to advance health in the United States. The purpose of this paper is to evaluate a recently-proposed health-related bill and an advocacy statement supporting its legislation

Part 1: Legislation Grid

Health-related Bill NameEnd Tuberculosis Now Act of 2022  
Bill NumberH.R. 8654 (, 2022).
DescriptionEnd Tuberculosis Now Act of 2022 underlines that the United States foreign assistance program has an obligation to end global tuberculosis (TB) pandemic through multifaceted interventions, including actions that support TB diagnosis and treatment among all adults and children and prevent new infections (, 2022; Kaiser Family Foundation, 2022). The bill also outlines the objectives and goals of TB-related policy, such as appropriate funding of comprehensive person-centered programs, capacity building among populations where the TB burden is high, and direct support to at-risk and impoverished populations.
Federal or State?Federal
Legislative IntentThe bill’s intent is to prevent, cure, and treat tuberculosis globally. Besides, the bill ensures that at-risk populations are identified and get appropriate support.
Proponents/ OpponentsProponents: Representative Ami Bera (, 2022).
Opponents: no opponent has been noted
Target PopulationAll adults and children with all forms of Tuberculosis and at-risk populations in the United States (, 2022; Kaiser Family Foundation, 2022).
Status of the bill (Is it in hearings or committees?)The bill is in the committees stage (House- Foreign Affairs)  
General Notes/CommentsThe bill focuses on a critical population health matter that deserves maximum attention from individuals, communities, health care providers, and governments. Generally, optimal health outcomes can only be achieved by protecting populations from infections, supporting health promotion programs, and identifying vulnerable populations. Since the bill will be instrumental in ending the TB pandemic and reducing health care costs, quick implementation is crucial. The federal government should also ensure that the United States foreign assistance program has adequate funding to achieve the health care goals outlined in the bill.

Part 2: Legislative Testimony/Advocacy Statement

Healthy populations are critical for a nation’s productivity and progressive economic well-being. The End Tuberculosis Now Act of 2022 will be instrumental to people’s health and well-being and should be quickly implemented. It will be crucial to health and well-being since it promotes preventive health, which helps to reduce deaths, disability, and health inequities (Franklin & Sleet, 2018). Besides, the bill applies a global approach to achieve internal health outcomes since it will advance measures for protecting Americans from foreign TB infections. Such an approach will further help the nation to achieve Healthy People 2030 goals.

TB rates vary with populations’ characteristics. Social determinants of income affect the legislation of the End Tuberculosis Now Act of 2022 since the variance in TB rates necessitates intervention programs specific to a population’s needs. Health research demonstrates a close link between TB and poverty since TB infections are high in low-income areas (Abou Jaoude et al., 2022). People living in low-income areas are likely to live in poorly ventilated and overcrowded conditions that are ideal for the spreading of TB bacteria. The rates of malnutrition and diseases such as HIV/AIDS are also high in low-income areas and increase TB resistance (Balinda et al., 2019). Such income-related outcomes necessitate adjustments in intervention measures since a universal approach cannot be used to promote health in populations with varying needs, vulnerabilities, and cultural practices.

Opponents should understand the implications of TB on populations, health care spending, and the progressive economic well-being of the nation. The best way to address them is through research and health statistics demonstrating the link between TB and adverse health outcomes. For instance, the Centers for Disease Control and Prevention (2020) reported that TB is the leading infectious disease in the world and claims approximately 1.5 million lives annually. As a result, multifaceted health promotion programs are vital. Abou Jaoude et al. (2022) stated that Stop TB Partnerships and health promotion programs have helped to reduce TB spending. Similar measures underlined in the End Tuberculosis Now Act of 2022 should be intensified to protect general and vulnerable populations.


Health care bills advance health through more funding, advocacy, and the protection of special populations, among other strategies. Implementing the End Tuberculosis Now Act of 2022 will be instrumental in attaining healthy and productive populations. As a result, quick implementation of the bill is essential and more support from legislators is needed as well. The government should also supplement such interventions with other health promotion programs, particularly in vulnerable communities where TB rates are high.


Abou Jaoude, G. J., Baena, I. G., Nguhiu, P., Siroka, A., Palmer, T., Goscé, L., … & Haghparast-Bidgoli, H. (2022). National tuberculosis spending efficiency and its associated factors in 121 low-income and middle-income countries, 2010–19: a data envelopment and stochastic frontier analysis. The Lancet Global Health10(5), e649-e660.

Balinda, I. G., Sugrue, D. D., & Ivers, L. C. (2019). More than malnutrition: a review of the relationship between food insecurity and tuberculosis. Open forum infectious diseases, 6(4), ofz102.

Centers for Disease Control and Prevention. (2020). Tuberculosis. (2022). H.R. 8654End Tuberculosis Now Act of 2022.

Franklin, R. C., & Sleet, D. A. (2018). Injury prevention and health promotion: A global perspective. Health Promotion Journal of Australia: Official journal of Australian Association of Health Promotion Professionals29(2), 113–116.

Kaiser Family Foundation. (2022). U.S. global health legislation tracker.

Wolstenholme, E., & McKelvie, D. (2019).The dynamics of care: Understanding people flows in health and social care. Springer.

Before the Affordable Care Act (ACA) went to Congress for voting in 2010, the Democratic Party made sure they had enough support for the Bill as possible. In 2009, House Speaker Nancy Pelosi and Democrats announced the H.R. 3962 Affordable Health Care for America (Davalon, 2022). To pass this Bill, the Democratic Party would need 60 votes in favor of H.R. 3962 (Davalon, 2022). The Democratic Party had the “policy window” open when they announced the Affordable Care Act to Congress, but it was shattered when Massachusetts Senator, Ted Kennedy, died in August 2009 (Davalon, 2022). Kennedy’s death jeopardized the Bill by removing a Democratic vote favoring healthcare reform. With the removal of Kennedy’s vote, you can begin to understand the effects elections and lobbying have when it comes to repealing or replacing the Affordable Care Act. The assigning of a new senator can tip the scales in favor or against the signing of a Bill. In this case, Republican Scott Brown lobbied over $263,700.00 and won the Massachusetts seat in the Senate (Scott Brown R-Mss Contributions from Lobbyists, 2012). Health Policy and Politics state that” winning an election or re-election, even at the local level, can be a very expensive proposition, costing millions of dollars” (p.48). Scott Brown was a Republican against the Affordable Care Act and voted no on the Bill, causing it to go back to Congress; this is one example of how legislators affect efforts to repeal or replace the ACA.  

Voters Views

         During the Trump administration, there was a debate among representatives on whether or not to remove the ACA. The discussion of eliminating the Bill and its effects on the American people made Americans fearful about how it would affect their health. The National Library of Medicine published a survey that showed 17% of Americans supported Trump’s Bill, with 56% in opposition and 26% undecided (Collier, 2017). The majority of citizens did not agree with the changes made by the Trump administration; therefore, Americans turned to activism and began to create movements on social media, protest at town hall meetings, and protest at Trump International Hotel and the Tower in New York (Collier, 2017). As the people began to inform themselves about the changes being made in politics, they also became aware of which politicians were voting for and against the ACA. The majority of Americans will vote for senators who support the ACA, and according to statistics stated above, that is 56% of Americans. American voters elect the House of Representatives, and as a result, the American people can dramatically influence Senators seeking reelection by voting for or against them.

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