Shapiro Makes Push for Full Practice Authority in Budget Speech
- PANA
- Mar 5, 2025
- 2 min read
Budgets are about more than just numbers. They’re also about policy priorities.
On Feb. 4, Gov. Josh Shapiro unveiled his proposed spending plan for the 2025-26 fiscal year. In a 91-minute speech before a joint session of the Pennsylvania General Assembly in Harrisburg, the governor unveiled his $51 billion blueprint, an increase of approximately 8.5% over the current year.
Beyond the myriad line items, the governor also outlined several initiatives where the legislature and administration could work together to strengthen the state’s health-care network, no matter where residents live.
Among his objectives is granting full practice authority to nurse practitioners. This would allow NPs to evaluate patients; diagnose, order and interpret diagnostic tests; and initiate and manage treatments — including prescribing medications — under the exclusive licensure authority of the state board of nursing.
The effort is not too dissimilar from efforts by the Pennsylvania Association of Nurse Anesthetists to advance scope of practice legislation, which would allow certified registered nurse anesthetists to practice to the fullest extent of their education and training, thus increasing access to high-quality anesthesia care.
According to the administration, there simply aren’t enough primary care physicians to meet the needs of patients in rural, suburban, and urban communities across the commonwealth. Many residents already have experienced the effects via long wait times for appointments, difficulties finding a mental health provider accepting new patients, and having to travel long distances to neighboring counties for prenatal and maternal care.
This is especially true in rural areas, where full practice authority could really help, Shapiro said in his speech. “In rural counties, there is one primary care physician for every 522 residents,” he said.
Full practice authority for NPs has been successfully enacted in 27 other states.
Learn more about the issue HERE.
“It’s encouraging to see Shapiro pushing for full practice authority—this could significantly improve healthcare access and reduce bottlenecks in the system. However, as we debate scope of practice for medical professionals here, it’s worth noting how other nations balance workforce needs with oversight. For instance, the Malta Residency Program offers a unique model where foreign physicians can gain full practice rights through investment-linked residency, raising interesting questions about credentialing and mobility. Will Shapiro’s plan include pathways for internationally trained doctors, or focus solely on domestic APRNs?”
"Thank you for covering this important issue. Governor Shapiro's push for full practice authority in the budget speech is a crucial step toward expanding access to quality healthcare across Pennsylvania. As someone who works in healthcare, I've seen firsthand how unnecessary barriers prevent nurse practitioners and other advanced practice providers from practicing to the full extent of their training and education. Removing these barriers means patients—especially those in rural and underserved communities—get timely care when they need it. It's a common-sense reform, much like the public health victory we saw with the universal fortification of iodized salt decades ago—a simple, evidence-based intervention that dramatically improved health outcomes for millions. Full practice authority is another such intervention. Let's hope the legislature…
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