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Coalition for Health Care Access Supports HB 1415 and SB 681

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Diverse coalition of 20 organizations represents consumer, business and health care stakeholders

A group of diverse organizations representing consumers and business, and a broad range of health care stakeholders have come together to form the Coalition for Health Care Access. This group of 20 business and consumer-advocacy groups, including AARP, Center for Public Policy Priorities, Texas Association of Business and the Texas Public Policy Foundation are supporting HB 1415 and SB 681, which will expand access to health care by removing outdated and costly regulatory barriers for Advanced Practice Registered Nurses (APRNs).

The groups lauded Sen. Kelly Hancock and Rep. Stephanie Klick for filing Senate Bill 681 and House Bill 1415, which would allow APRNs to practice to the full extent of their training and licensure and place them under the exclusive regulatory authority of the Texas Board of Nursing.

APRNs are highly-skilled health care professionals who have Masters or doctorate-level training. They provide primary care, mental health, women’s health, disease management and other services. Outdated and unnecessary regulations that function as a hidden tax on health care are preventing APRNs from practicing to the full extent of their license.

To practice in Texas, APRNs are required to sign a contract with a delegating physician, who is under no obligation to ever see the patients or be in the same city as the APRN. A 2016 study found that some APRNs were forced to pay their delegating physician as much as $120,000 per year. The Department of Defense, U.S. Department of Veterans Affairs, and 21 other states do not require delegation agreements, and states like New Mexico and Arizona are actively recruiting Texas-trained APRNs, where they face fewer regulatory burdens and lower practice costs.

“Texas is a big state with a big problem of too few medical care providers,” said AARP Texas Director Bob Jackson. “The Legislature can improve access to care for Texans by lifting restrictions that keep Advanced Practice Registered Nurses from practicing to the full extent of their licensure and training.”

“We are pleased to see Sen. Hancock and Rep. Klick introduce common-sense legislation that would enhance the ability of Advanced Practice Registered Nurses to provide health care across our great state,” said Anne Dunkelberg, Associate Director of the Center for Public Policy Priorities. “Given the current federal threat to roll-back affordable insurance and state proposals to cut Medicaid funding, now is the time to ensure we're doing everything we can to provide high-quality affordable health care to the most Texans.”

“Controlling health care costs is a priority for business,” said Amanda Martin, Texas Association of Business Governmental Affairs Manager for Health Care.  “APRNs are a way to both improve access to care and control costs.  It is critically important that we do both in Texas.”

Medically underserved areas and regions with low-income populations are most negatively impacted by regulations on APRNs. Without access to primary care, patients end up in costly emergency rooms, or with more serious, un-treated illnesses.

“It's time to release our advanced practice nurses to provide good care to Texans who currently have none at all,” said Dr. Deane Waldman, Director, Center for Health Care Policy at Texas Public Policy Foundation

Nurse practitioners, nurse midwives, certified registered nurse anesthetists, and clinical nurse specialists play a vital role in caring for Texans and addressing our state’s growing and changing health care needs. Allowing APRNs to do the job they are trained to do will go a long way toward improving access to vital health care in Texas.


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