Texas made it onto the top ten list again, but this time, it was not on a good list. In The New England Journal of Medicine, February 10 issue, was an article that ranked Texas as #3 in the nation for states facing the greatest challenge with ObamaCare’s Medicaid expansion. The challenge they describe has nothing to do with the state’s budget, though we know that is in serious trouble from Medicaid also. Rather the problem is access to care. “Eight states – Oklahoma, Georgia, Texas, Louisiana, Arkansas, Nevada, North Carolina, and Kentucky – face the greatest challenges. These states are expected to have large Medicaid expansions yet now have weak primary care capacity. In the absence of additional efforts, the demand for care by newly insured patients could outstrip the supply of primary care providers in these states.”
There is something we can do to improve access to care – give Advanced Practice Nurses (APNs) the authority to practice as they have been educated and trained to do. Restrictive scope of practice laws cause Texas to be on yet another list that’s not so good – the state with the most restrictive laws for Nurse Practitioners. In other states where APNs have been granted independent practice, the outcomes are equal to those of physicians. Further, the state can educate and get into the workforce eight APNs for the same time and money it takes for one primary care doctor. It’s time to modernize our laws and better utilize our Advanced Practice Nurses.