Inside the Beltway - June 2026

Inside the Beltway is a member-only benefit developed by NAPNAP’s Health Policy Team to keep members up to date on key policy issues at the federal level.

From Policy to Prevention: Advancing Firearm Violence Research to Protect Children

Contributed by Health Policy Committee Member Noelia MaGowan, CPNP-PC

Based on CDC mortality data, gun violence is the leading cause of death for children and adolescents, ages 1-19, in the United States. Analyses of these CDC data indicate that, over the past decade, firearm deaths among youth have risen by nearly 70%, meaning even more children are living with nonfatal injuries or other direct exposure to gun violence. As June brings National Safety Month, this is an important moment to examine how federal policy on firearm injury research shapes our ability to prevent harm and heal the children we serve.

For decades, federal investment in firearm injury research was minimal, largely because the 1996 Dickey Amendment signaled that injury‑prevention funds could not be used in ways that might be seen as promoting gun control. This created a chilling effect that significantly reduced federally supported gun violence research and left the U.S. without the kind of sustained evidence base that has helped drive major reductions in other kinds of deaths.

Although Congress has only recently begun restoring dedicated funding at the Centers for Disease Control (CDC) and National Institutes of Health (NIH), firearm violence research and/or prevention programs remain small, politically vulnerable and insufficient to meet the scope of the problem. The Gun Violence Prevention Research Roundtable letter, sent in March to the chairs and ranking members of the House and Senate Appropriations Committees, requests $35 million for the CDC, $25 million for the NIH and $1 million for the National Institute of Justice (NIJ) specifically to support firearm injury and firearms‑safety research; however, the initial House HHS appropriations bill eliminates all funding for firearms safety research at the CDC, restricts firearm-related research at the NIH and SAMHSA, and prohibits research that treats crimes committed with a firearm as a public health epidemic. In addition to signing on NAPNAP invited chapters to sign on to this advocacy measure, underscoring that pediatric‑focused nurse practitioners view gun violence as a preventable public health problem and support a robust federal research agenda to guide solutions.

Health systems are already showing what is possible when firearm violence prevention research and clinical care are aligned. At Northwell Health, a large system headquartered in New Hyde Park, NY, pediatric surgeon Dr. Chethan Sathya leads a gun violence prevention program and serves as director of Northwell’s Center for Gun Violence Prevention. An NIH‑funded firearm‑injury prevention researcher, he works with federal partners and lawmakers to translate health‑system data into policy‑relevant solutions, while nurses and pediatric nurse practitioners drive front‑line screening, counseling and injury‑prevention efforts in settings such as trauma services and pediatric inpatient care.

Current federal appropriations discussions will determine whether programs like these can expand and whether other systems can follow suit. Calls from pediatric and public health coalitions for increased funding at CDC, NIH and the NIJ’s research agencies are actionable requests for the resources needed to answer questions our patients and families are asking every day: How do we keep our children safe at school, at home and in their communities? How do we support children when exposed to firearm violence?

As NAPNAP members, we can use our clinical experience to inform this conversation. Sharing patient stories, with appropriate protections, when engaging with our elected officials about the importance of firearm injury research and supporting coalition efforts to expand federal and state investments in research and prevention are concrete ways to move from responding to tragedies to preventing them. By focusing on policies grounded in high‑quality data and effective interventions, we can help ensure that every child has the chance to grow up safe from gun violence and its lasting psychological scars.

References:

KFF. (2026, March 11). Child and adolescent firearm deaths: National trends and variation by demographics and states. KFF. https://www.kff.org/mental-health/child-and-adolescent-firearm-deaths-national-trends-and-variation-by-demographics-and-states/
Harvard Gazette. (2026, January 27). Parental firearm injury linked to surge in children’s psychiatric diagnoses. Harvard University. https://news.harvard.edu/gazette/story/2026/01/parental-firearm-injury-linked-to-surge-in-childrens-psychiatric-diagnoses/
Yale School of Public Health. (2024, July 1). Lifting of federal funding ban tied to increase in gun violence research. Yale University. https://ysph.yale.edu/news-article/lifting-of-federal-funding-ban-tied-to-increase-in-gun-violence-research/
American Psychological Association. (2021, March 31). A thaw in the freeze on federal funding for gun violence and injury research. https://www.apa.org/monitor/2021/04/news-funding-gun-research
Everytown for Gun Safety Support Fund. (2023). Not enough funding for gun violence prevention research. https://everytownresearch.org/issues/gun-violence-prevention-research-funding
The Trace. (2026, February 2). After Trump’s cuts, who’s going to fund gun violence prevention? https://www.thetrace.org/2026/05/gary-lawsuit-gun-industry-indiana/
Gun Violence Prevention Research Roundtable. (2026, March 25). Letter to the Chairs and Ranking Members of the House and Senate Appropriations Committees regarding FY 2027

Key NAPNAP Advocacy Activities

NAPNAP responded to the May 1 release of the Department of Education’s “Reimagining and Improving Student Education – Federal Student Loan Program Final Regulations (Docket ID ED-2025-OPE-0944), which failed to designate post-baccalaureate nursing as a “professional degree” qualifying for higher amounts of annual and total federal student loans, issuing a statement objecting to the rule, endorsing the “Nursing is a Professional Degree Act” (H.R. 8691/S. 4568) and issuing a call to action urging NAPNAP members to encourage their members of Congress to cosponsor the legislation.
NAPNAP met with congressional staff to discuss how a pediatric micro-credential could align with the priorities of the administration and Congress to expand health care workforce development and support initiatives to increase the global frontline health workforce.
NAPNAP coordinated with staff for Rep. Kim Schrier (D-WA) on the introduction of the “Strengthening the Vaccine for Children Program Act of 2026” (H.R. 8425), expanding the program to include children enrolled in the Children’s Health Insurance Program (CHIP) and temporarily requiring providers to be paid no less than Medicare reimbursement rates for vaccine administration and counseling services provided to children.
NAPNAP and other organizations met with professional staff for the majority and minority members of the House and Senate Labor-HHS-Education Appropriations Subcommittees to advocate for increased fiscal 2027 funding for Title VIII nursing workforce development, nursing research and immunization programs, as well as provisions to prevent the Department of Education from implementing student loan regulations that fail to acknowledge post-baccalaureate nursing as professional degrees.
NAPNAP joined the Nursing Community Coalition in celebrating National Nurses Week, meeting with members of Congress and staff on May 12 to advocate for nursing priorities and hosting a “Thank a Nurse” Capitol Hill reception with the House and Senate Nursing Caucuses.

House Appropriators Boost Nursing Funds, Block Student Loan Rule

The House Appropriations Committee voted last week to advance a fiscal 2027 funding bill that would provide a small increase in funding for nursing workforce programs and force the Department of Education to recognize post-baccalaureate nursing as a professional degree. Adopted on a party-line vote after a 12-hour markup, the Labor-HHS-Education bill would cut funding for the Department of Health and Human Services by 4 percent, or $5.8 billion, but would increase total funding for the Title VIII nursing workforce development programs by $2 million, up to $307.472 million.

The committee also adopted a bipartisan manager’s amendment that would block the Department of Education from imposing lower borrowing caps on students in post-baccalaureate nursing programs. The bill prohibits the agency from administering federal student aid in “a manner that does not designate advanced nursing programs as professional degree programs,” blocking provisions of the department’s final student loan regulations that rejected calls to designate nursing as eligible for higher loan limits.

As they did in the fiscal 2026 budget, House appropriators eliminated all funding for the Nursing Workforce Diversity program, a $22.343 million cut. But the committee offset the cut by increasing funding for the Nurse Corps Loan Repayment and Scholarship Program by $20 million and by providing an additional $3.343 million for the Nurse Education, Practice, Quality, and Retention Program, bringing total funding to $68.756 million. The panel also allocated an additional $1 million to the Nurse Practitioner Optional Fellowship Program, bringing the total to $8 million, while retaining the other Title VIII programs, including the Advanced Nursing Education Program and the Nursing Faculty Loan Program, at their current funding levels.

NAPNAP Joins Lawsuit Challenging Student Loan Limits

NAPNAP joined a broad coalition representing professionals with degrees in nursing, counseling, public health and education last month in filing a federal lawsuit challenging the Department of Education policy that would exclude pediatric APRNs and a wide range of professionals from accessing adequate financial aid through the agency’s Direct Loan program. Along with the American Association of Nurse Practitioners (AANP), the American Association of Colleges of Nursing (AACN), the National Education Association (NEA), the Association of Schools and Programs of Public Health (ASPPH) and the American Association for Marriage and Family Therapy (AAMFT), NAPNAP petitioned the District of Columbia federal district court to block the rule, charging that it violates the Administrative Procedure Act. Unless blocked by the court, the new restrictions are due to be implemented on July 1.

The lawsuit is one of four separate legal challenges seeking to block the regulations. More than 20 states filed a lawsuit in a federal district court in Maryland, asking the judge to block certain parts of the rule. The attorneys general argued that the definition the department’s definition of professional degrees is too “narrow” and that Congress did not intend to limit the professions eligible for the higher limits in that way, adding that the caps will force many students, particularly those in critical health care fields that face shortages, to rely on more expensive private loans, take on higher levels of debt, delay completing their education or abandon these programs altogether. The American Nurses Association joined with nine other nursing organizations in filing a separate suit challenging the rule in a Massachusetts federal district court, and physician assistants’ groups also filed a separate lawsuit.

Congress Pushes Back on Student Loan Restrictions

In addition to lawsuits and funding restrictions, members of Congress are filing multiple bills seeking to reject or revise the Department of Education’s student loan rule. Senate Nursing Caucus co-chairs Sens. Jeff Merkley (D-OR) and Roger Wicker (R-MS) introduced the “Nursing is a Professional Degree Act” (S. 4568) to add post-baccalaureate nursing degrees to the list of degrees considered “professional degrees” by the agency and codifying the expanded list in statute. A companion bill (H.R. 8691), filed by House Nursing Caucus leaders Reps. Jen Kiggans (R-VA) and Dave Joyce (R-OH), is cosponsored by 10 Republicans, a Democrat, and an independent. NAPNAP is calling on members to contact their members of Congress and urge them to cosponsor the bills.

Sen. Merkley was also joined by Sens. Angela Alsobrooks (D-MD), Bernie Sanders (I-VT) and Chuck Schumer (D-NY) in filing a resolution (S.J. Res. 196) that would disapprove the entire student loan rule and prohibit the Education Department from issuing a substantially similar regulation. His Oregon colleague, Democratic Rep. Suzanne Bonamici, filed a companion resolution (H.J. Res. 189) with 55 cosponsors.

Trump Order Renews Review of Child Vaccine Schedule

Despite a lawsuit that blocked an effort to revise the childhood vaccine schedule earlier this year, President Trump issued an executive order last month directing the Centers for Disease Control and Prevention and its Advisory Committee on Immunization Practices (ACIP) to review a report calling for the U.S. to reduce the number of vaccines routinely recommended for children and “take any appropriate steps to update” the schedule. The report, co-authored by Martin Kulldorff, a Swedish biostatistician and epidemiologist selected by HHS Sec. Robert F. Kennedy, Jr. to chair the vaccine advisory panel, argued that the U.S. should recommend fewer vaccines for children because other “peer nations,” like Denmark, recommend fewer.

In January, Kennedy’s then-acting CDC director, Jim O’Neill, signed off on an overhaul of the childhood vaccine schedule without waiting for ACIP to vote on the changes. O’Neill approved an order removing rotavirus, meningococcal disease, hepatitis A and influenza vaccines from its list of routinely recommended vaccines, prompting a legal challenge from several public health groups, including the American Academy of Pediatrics. A Boston federal district judge blocked the changes to the immunization schedule and stayed Kennedy’s appointments to ACIP after the secretary fired all of the previous members and replaced them with panelists more closely aligned with his own skepticism about vaccines. The executive order appeared to be an attempt to work around the judge’s order.

Stay Up to Date

The summer is a great time to catch up on past seasons’ Child Health Policy Learning Collaborative webinars. Log into napnap.org to view the CHPLC Archive. Be sure to follow NAPNAP on social media to view weekly TeamPeds Policy Perspectives featuring timely policy and advocacy information from our Health Policy Committee chairperson.

In Other News…

Medicaid Work Reporting, Payment Rules Threaten Children’s Access to Care
Health care providers and patient advocates are sounding the alarm over regulations issued by the Centers for Medicare and Medicaid Services to implement “community engagement” requirements for Medicaid enrollment, effective at the end of July. The interim final rule requires affected adults to document at least 80 hours per month of qualifying activities, such as work, education, or community service, unless they qualify for an exception or exclusion. Advocates are concerned that the rule goes beyond the reporting requirements provisions adopted by Congress in the One Big Beautiful Bill Act, increasing compliance mandates and making it more difficult for enrollees to qualify for exemptions or exclusions, narrowing the definition of “medically frail” exemptions and limiting enrollees’ ability to self-attest to verify community engagement. While children are not directly subject to the requirements, advocates are worried that parents may misunderstand notices, miss paperwork, or avoid enrollment altogether, leading eligible children to lose coverage or never enroll.

The work requirement rule follows the issuance of proposed regulations limiting Medicaid state-directed payments that states use to require Medicaid managed care plans to increase payments to providers. The proposal would extend new payment limits across state-directed payment arrangements and certain fee-for-service targeted practitioner payments, phasing out existing payment arrangements over time. Providers of children’s care are warning that reducing states’ ability to use directed payments will strain pediatric delivery systems, particularly children’s hospitals and practitioners that rely heavily on Medicaid and CHIP revenue.

Administration Seeks to Increase Political Review of Federal Grants
The White House Office of Management and Budget issued regulations last month that could result in the most consequential revision of federal grant administration rules in more than a decade. The proposed rule would uproot what’s known as the “Uniform Guidance,” changing how every federal grant is reviewed, approved and potentially terminated. The most significant change: senior political appointees, not career program officers or independent peer reviewers, would be required to personally sign off on discretionary grants before awards are made, making sure they “demonstrably advance the President’s policy priorities.” The rule explicitly bars appointees from simply deferring to expert recommendations. For programs funded through HHS – pediatric health research, early childhood development, maternal and child health grants – the rule would introduce a political filter with no precedent in the modern grantmaking era.

Equally concerning is expanded termination authority. Under the proposal, agencies could cancel active grants simply by citing inconsistency with “agency priorities,” without requiring a finding of noncompliance. Entities receiving federal funds would be required to restructure or eliminate equity-focused programs, and institutions with high indirect costs would be at a disadvantage for funding. Multi-year research grants can be terminated mid-stream, journal publication costs would be disallowed and nonprofits with advocacy, social justice, or equity missions could be declared ineligible for funding. Conference attendance, professional memberships and journal subscriptions would require agency pre-approval or be disallowed.