Three Nurses Serve in Congress: Where They Agree, Disagree & What It Means for Healthcare
- All three nurses co-supported the Title VIII Nursing Workforce Reauthorization Act of 2025, the clearest sign that shared professional identity can cut across party lines on issues directly affecting the profession.
- The One Big Beautiful Bill was the defining split: Underwood voted no, Biggs voted yes without reservation, and Kiggans voted yes after publicly opposing its Medicaid cuts.
- Kiggans led a bipartisan coalition to extend ACA premium tax credits, but those credits ultimately expired anyway when the final bill she voted for didn't include them.
Right now, three registered nurses are serving in the U.S. House of Representatives: Rep. Lauren Underwood (D-IL-14), Rep. Jen Kiggans (R-VA-02), and Rep. Sheri Biggs (R-SC-03). They bring different nursing backgrounds, represent very different districts, and hold very different political views. But their time in the 119th Congress has produced a nuanced legislative record, with genuine collaboration on nursing workforce issues alongside deep disagreements on the biggest health policy fight of the year.
Here's where they've stood, what they've done together, and where the fault lines run.
Who They Are
- Lauren Underwood is the most senior nurse in Congress, now in her fourth term representing the western Chicago suburbs. A registered nurse with a BSN from the University of Michigan and dual master's degrees from Johns Hopkins, she worked as a senior advisor at the Department of Health and Human Services before running for Congress in 2018. She serves on the House Appropriations Committee and co-chairs the Congressional Nursing Caucus as a vice chair alongside Kiggans. She is consistently one of the most reliable Democratic votes in the House, having voted with President Biden's stated position 100% of the time during the 117th Congress, and has voted with President Trump's position just 6.5% of the time in the current session.
- Jen Kiggans is a board-certified adult-geriatric nurse practitioner who flew Navy helicopters for ten years before going back to school at Old Dominion University and Vanderbilt. Now in her second term representing Virginia Beach and the Eastern Shore, she's carved out a reputation as a bipartisan member of the House Republican conference. She is a member of the Problem Solvers Caucus and the Republican Governance Group, and she consistently identifies her nursing background as the lens through which she approaches health policy.
- Sheri Biggs is the newest of the three, sworn in January 3, 2025 after winning South Carolina's 3rd Congressional District. A board-certified family nurse practitioner and psychiatric mental health NP with a Doctor of Nursing Practice from Samford University, she spent over three decades in healthcare, from ICU nursing to nursing home administration to the Air National Guard, where she holds the rank of lieutenant colonel. She is firmly aligned with the conservative wing of House Republicans, and her legislative priorities have centered on border security, veterans' services, and mental health, reflecting both her military service and her clinical work with veterans.
Where They've Worked Together: The Nursing Workforce
On issues that directly affect the nursing profession, Underwood and Kiggans have a consistent track record of crossing party lines together. Biggs has been less visible in this space, but her advocacy for nurse education funding is notable.
Title VIII Reauthorization
The clearest example of bipartisan teamwork between the two caucus vice chairs came in May 2025, when Underwood and Kiggans, along with caucus co-chairs Rep. Dave Joyce (R-OH) and Rep. Suzanne Bonamici (D-OR), jointly introduced the Title VIII Nursing Workforce Reauthorization Act of 2025 (H.R. 3593). The bill reauthorizes the primary source of federal funding for nursing education in the United States, supporting programs that train nurses for rural and medically underserved communities, fund nursing faculty, and expand clinical education capacity.
The bill was endorsed by more than 50 organizations, including the American Nurses Association and the American Association of Colleges of Nursing, and it advanced out of subcommittee in September 2025.
"As a nurse practitioner, I've seen firsthand how essential nurses are to the strength and sustainability of our healthcare system," Kiggans said at the bill's introduction. "This bipartisan, bicameral bill tackles the nursing shortage head-on by expanding clinical education opportunities, increasing the number of trained nurses, and investing in the educators who prepare them."
Underwood framed it similarly: "Nurses are at the forefront of promoting public health and providing quality, affordable health care to our communities and it is essential that we continue to support and grow the nursing workforce."
Biggs, while not an original co-sponsor, has independently pushed on nurse education. In a letter to Education Secretary Linda McMahon, she urged the Department to protect access to nurse practitioner education in rural communities, warning that a proposed rule could make it harder for future NPs to afford their training.
Advocating for 2026 as "The Year of the Power of Nurses"
In January 2026, Underwood introduced H. Res. 1010, a resolution recognizing 2026 as "The Year of the Power of Nurses" in celebration of the 130th anniversary of the American Nurses Association. The companion Senate measure was introduced by Sen. Jeff Merkley (D-OR), who leads the Senate Nursing Caucus. While the resolution is largely symbolic, it reflects the ongoing effort by nurse-legislators to elevate the profession's voice in policy conversations.
The Congressional Nursing Caucus
All three nurses benefit from the platform of the Congressional Nursing Caucus, which relaunched at the start of the 119th Congress with more than 40 bipartisan members. Underwood and Kiggans serve as vice chairs; Joyce and Bonamici serve as co-chairs. The caucus has focused on the nursing shortage, the workforce pipeline, and supporting nurses' ability to practice at the full extent of their training. Biggs is not listed among caucus leadership, but her public statements frequently invoke her clinical background when addressing health policy.
Where They've Diverged: The Biggest Healthcare Votes of the 119th Congress
The bipartisan goodwill on nursing workforce issues largely evaporates when the votes get bigger and the politics get sharper.
The One Big Beautiful Bill Act
The defining healthcare vote of the 119th Congress was the One Big Beautiful Bill Act (H.R. 1), signed into law on July 4, 2025. The law includes the largest cuts to Medicaid in the program's history, estimated to result in 11.8 million people losing health coverage by 2034, according to the Congressional Budget Office. The law also declined to extend enhanced Affordable Care Act premium tax credits that expired at the end of 2025, a move expected to affect millions more.
The three nurses in Congress voted exactly as their party affiliations predicted, but the story is more complicated than a party-line split, at least for Kiggans.
- Biggs voted yes. Her public statement framed the bill as a "monumental step forward in restoring common sense in Washington," citing border security, personal freedom, and fiscal responsibility. "It may not be perfect," she said, "but it delivers big wins for border security, personal freedom, and fiscal responsibility."
- Kiggans had a different path. She had previously signed a letter to congressional leadership warning that cuts to Medicaid would harm vulnerable patients, noting that "balancing the federal budget must not come at the expense of those who depend on these benefits for their health and economic security." Despite that stance, she ultimately voted yes, providing one of the votes in the narrow 215-214 House passage. In her explanation, she said the bill "strengthens Medicaid and food assistance by reducing waste and fraud and introducing work requirements for able-bodied adults without dependents."
- Underwood voted no. She has been a consistent and vocal opponent of Medicaid cuts throughout her tenure, citing both her nursing background and her own experience as a person with a pre-existing condition. She has framed the bill's provisions as a direct threat to the patients nurses care for every day.
The ACA Premium Tax Credit Fight
The lead-up to the One Big Beautiful Bill produced one of the more interesting moments of cross-party collaboration in the 119th Congress, and Kiggans was at the center of it.
When it became clear that enhanced ACA premium tax credits were set to expire at the end of 2025, Kiggans co-led a bipartisan coalition of 38 House members to introduce the CommonGround for Affordable Health Care Act. The bill proposed a two-year extension of the credits, with anti-fraud guardrails and PBM reforms. Over 30,000 constituents in her Virginia district relied on the credits.
"As a geriatric nurse practitioner, co-chair of the nursing caucus, and one of two NPs in Congress, healthcare affordability is an important issue to me personally and professionally," Kiggans said. "The CommonGround framework is proof that bipartisan solutions are possible."
In the end, the credits were not extended. The One Big Beautiful Bill, which Kiggans ultimately voted for, did not address the expiration of the enhanced tax credits. Kiggans later voted against a Democratic discharge petition for a clean three-year extension, saying it lacked the reforms she wanted. Underwood supported the extension. Biggs opposed it.
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Themes and Takeaways
A few patterns stand out when you look at the full record of these three nurses in Congress.
- Nursing workforce issues remain mostly bipartisan. When the question is about investing in the nursing pipeline, funding nursing education, or addressing the shortage, Underwood and Kiggans consistently find common ground. The Title VIII reauthorization, the Nursing Caucus itself, and Biggs's advocacy for rural NP education all reflect a shared professional identity that cuts across party lines, at least on process questions.
- Medicaid is where the agreement ends. The divergence on the One Big Beautiful Bill was stark, and the Medicaid provisions are the most consequential for nursing practice. The law also included a ten-year moratorium on the Biden-era nursing home staffing mandates, a provision that nursing home advocates had mixed feelings about. Underwood opposed the whole package. Biggs supported it fully. Kiggans expressed reservations but voted yes anyway.
- Kiggans occupies the most complicated political position. She is the only one of the three who has genuinely tried to play both sides of the healthcare debate, pushing for ACA subsidy extensions while ultimately voting for the bill that let them expire. Her nursing identity shapes her language and her coalition-building, but her votes have often landed with her party when it counted. Roll Call noted in March 2026 that Kiggans "has a track record of breaking with her party on some big issues but not tanking legislation."
- Biggs brings a different kind of nursing voice to the Hill. Where Underwood and Kiggans are both closely identified with mainstream nursing policy advocacy, Biggs's legislative footprint is more aligned with her conservative politics than her clinical background. Her nursing identity surfaces most clearly in her mental health work, particularly the Hope Heals Act, which draws on her years as a psychiatric mental health NP. Her advocacy for veterans' mental health reflects the same clinical perspective.
- All three have introduced or supported nursing-specific bills that are still working through committee. None of the major nursing workforce legislation from the 119th Congress has been signed into law yet. The Title VIII reauthorization passed subcommittee in September 2025 but has not had a full House vote. That's a story worth watching as the second session of the 119th Congress moves toward the 2026 midterms.
The Bottom Line
The three nurses currently serving in Congress share a profession, a commitment to patient care, and a willingness to invoke their clinical experience when making the case for their votes. On nursing workforce issues, that shared background has produced real bipartisan legislation. On the bigger healthcare fights of the 119th Congress, party alignment has won out over professional identity, particularly on Medicaid and the ACA.
Whether having nurses in Congress produces meaningfully different healthcare policy than having non-nurses remains an open question. What their record shows is that the shared experience of clinical practice is real and it matters, especially when the legislation is directly about nursing. When the stakes get higher and the politics get partisan, nurses seem to vote like everyone else in their party.
🤔 What do you think about the voting record of these nurses? Share your thoughts in the comments below.
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