Nearly every state now participates in major interstate compacts that let doctors and nurses practice across state lines, expanding the healthcare workforce and giving patients more options. Yet when it comes to advanced practice nurses—the clinicians who could most immediately fill the gap in primary care—fewer states have jumped on board. The nation is rapidly adopting streamlined licensing for physicians and nurses, but the Advanced Practice Registered Nurse (APRN) Compact remains stuck, and patients are paying the price.
Only four states have joined the APRN Compact, with five more considering participation. The compact has not yet taken effect, as it requires seven states to take effect. The compact would allow four additional groups of clinicians to work across state lines: Nurse Practitioners, Certified Registered Nurse Anesthetists, Clinical Nurse Specialists, and Certified Nurse-Midwives. Part of the delay is due to how new it is—the first states joined in 2021.
But newness isn’t the only obstacle. The American Medical Association (AMA) is pushing back, arguing the compact would undermine state scope-of-practice laws—regulations that limit APRNs in many states to practice only under physician supervision.
Justin Leventhal is a senior policy analyst for the American Consumer Institute, a nonprofit education and research organization. For more information about the Institute, visit www.TheAmericanConsumer.Org or follow us on X @ConsumerPal.