NCPA - National Center for Policy Analysis

States Seek to Redefine Who Can Provide Care

February 14, 2013

As states expand health care coverage as mandated by the Affordable Care Act (ACA), they are likely to experience a shortage of doctors in attempts to treat an influx of newly insured patients. States are taking various measures to solve this problem, says the Los Angeles Times.

Take California, where state Senator Ed Hernandez says there will not be enough doctors to treat new patients.

  • Sen. Hernandez has made proposals that seek to redefine who can provide coverage.
  • The new proposal would allow physician assistants to treat more patients, nurse practitioners to set up independent practices and pharmacists, and optometrists to act as primary care providers.
  • Hernandez's proposed changes would shake up the medical establishment in California and could affect the success of the ACA in California.

The National Conference of State Legislatures says that since January 1, more than 50 proposals have been launched in 24 states that alter what health professionals are licensed to do.  The new proposals join the more than 350 laws that have already been enacted in the last two years.

  • Just 16 of California's 58 counties have the federal government's recommended supply of primary care physicians, with more than 30 percent of the state's doctors nearing retirement.
  • It takes more than a decade to train a physician and the pace of expected graduates will not keep up with the expansion in patients needing care.
  • Doctors say physician assistants and other midlevel professionals are best deployed in doctor-led teams and that allowing these health workers to set up independent agencies would create voids in the clinics, hospitals and offices that they currently work in.

Whether or not these midlevel professionals are granted new responsibilities that are within their training, the fundamental problem of not having enough doctors to treat the growing number of patients in the U.S. health care system still exists.

Source: Michael Mishak, "State Lacks Doctors to Meet Demand of National Health Care Law," Los Angeles Times, February 9, 2013.


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