National Programs Update

Federal Actions Threaten End-of-Life Care and Options

The Washington, D.C., Death with Dignity Act under attack

Compassion & Choices is defending Washington, D.C.’s medical aid-in-dying law from ongoing threats. New leadership in the U.S. Senate and an administration open to rolling back the district’s autonomy have emboldened efforts to repeal the law.

We strongly oppose the efforts to repeal the law through the federal appropriations process and attempts to terminate home rule through the Bringing Oversight to Washington and Safety to Every Resident (BOWSER) Act. 

We pursue this mission with allies in Congress, including Rep. Brittany Pettersen (D-CO), who will reintroduce the Patient Access to End of Life Care Act this year. The bill would exempt current and future states where medical aid in dying is authorized from the Assisted Suicide Funding Restriction Act, which currently bars federal funding or assistance for medical aid in dying — limiting access to this end-of-life option.

Continued federal policy efforts underway

We are collaborating with Sen. Richard Blumenthal (D-CT) and Rep. Nanette Barragán (D-CA) to reintroduce the Compassionate Care Act, which promotes advance care planning and addresses Medicare coverage limitations for hospice care.

Compassion & Choices is monitoring executive orders, legal challenges to those orders, and cuts to the federal workforce and funding — particularly at the Centers for Medicare and Medicaid Services (CMS), where hospice and long-term care services could be affected.

A Biden-era federal regulation improved long-term care staffing ratios in nursing homes, requiring a registered nurse on-site 24/7 and at least 3.48 hours of nursing care per resident each day. On April 7, 2025, a federal judge in Texas struck down this rule, stating that CMS exceeded its authority and that only Congress can set such staffing requirements. The new administration is unlikely to challenge the ruling. Nursing home residents at the end of life are likely to face staffing shortages and inadequate care as a result.

Meanwhile, the Drug Enforcement Administration (DEA) has proposed a new rule restricting telehealth access. If finalized, the rule would create barriers to accessing necessary medications for palliative care and hospice patients. We have urged the DEA to work with Congress to advance a safe, permanent pathway for practitioners to continue providing telehealth care to all patients.

Across the nation, hospital mergers that restrict access to healthcare options pose a threat to patient choice. These mergers can be detrimental to individuals and families seeking end-of-life options. They can limit the ability to access medical aid in dying, turn off a pacemaker or defibrillator, and remove life-sustaining treatments to allow a natural death. That’s why in Oregon, Compassion & Choices and partner organizations are fighting back — to keep control in your hands, not those of for-profit corporations and religious institutions. This year, Compassion & Choices joined a coalition of nonprofits to file an amicus brief with the Ninth Circuit Court of Appeals in support of dismissing a lawsuit challenging the state’s Health Care Market Oversight (HCMO) program. Established in 2021, HCMO reviews healthcare mergers, acquisitions and affiliations to ensure they promote equitable, accessible and high-quality care for all Oregonians. Compassion & Choices remains committed to the steady, essential work of protecting patient-centered care for everyone, regardless of where they live.