California Eases Restrictions on Nurse Practitioners

J. Justin Wilson
J. Justin Wilson · September 30, 2020

Late Tuesday, California Gov. Gavin Newsom signed a bill that will significantly ease restrictions on nurse practitioners (NPs), nurses with advanced degrees who can diagnose symptoms, treat patients and prescribe medicine. Prior to reform, California was one of 22 states that barred NPs from working, or even volunteering in hospitals, unless they were supervised by or collaborated with a physician. 

But under the newly signed AB 890, NPs who have been in practice for at least three years, will finally be able to operate independently, without physician supervision. Once the new law takes effect in 2023, California will become the 16th state to grant NPs with full practice authority following a transition period. Another 13 states let NPs practice independently immediately after becoming licensed. 

“Physician supervision requirements are completely unnecessary and are hurting states’ efforts to respond to Covid-19,” said Institute for Justice Senior Attorney Erica Smith, who submitted testimony in favor of the bill. “Nurse practitioners want to be able to volunteer now, but they are getting caught in red tape.”

Nurse practitioners across the country have struggled to find supervising physicians, either because of limitations in their medical malpractice insurance, or an unwillingness to take on additional responsibilities during this chaotic time. In addition, NPs must often pay physicians thousands of dollars for supervision.

Yet research from numerous organizations across the political spectrum, including the Brookings Institution and the American Enterprise Institute, have found that empowering NPs could have significant benefits for health care efficiency without sacrificing quality of care. Instead, the evidence suggests that restrictions on nurse practitioners serve only to raise prices and protect doctors from competition. 

With many hospitals in desperate need of medical personnel during the Covid-19 pandemic, it may also cost lives. For this reason, multiple organizations and individuals, including the U.S. Secretary of Health and Human Services, have called on states to lift restrictions on NPs during the pandemic.