GOP Lawmaker: Nurse Empowerment Solution To Obamacare Shortage

By John Celock

A Republican state legislator in New Jersey says that legislation that she is pushing to empower nurse practitioner in the state will increase what she said is a shortage of health care access under the Affordable Care Act.

Assemblywoman Nancy Munoz (R-Summit), a nurse, told an AARP conference call Wednesday morning that while the ACA has increased the amount of those insured she does not see the amount of health care providers increasing. She said that her Consumer Access to Healthcare bill would allow nurse practitioner in the state to further practice medicine without having doctors sign off on their moves.

“We have found that through Obamacare that the amount of insured pat has expanded but the amount of providers has not expanded,” Munoz said in response to a question from a Barbara from Cranford regarding a decrease in Medicare reimbursement rates from the ACA.

Munoz said that nurse practitioners in the state can currently prescribe medication and diagnostic treatments, but have to have doctors approve these actions under what she said is a “joint protocol agreement.” Munoz, a member of the health and human services committee, said under the agreement nurse practitioners have to pay the doctors for signing off. Munoz noted that she is an “advanced practitioner nurse” in the call.

Munoz used the call to note that her late husband, former Assemblyman Eric Munoz (R-Summit) was a physician and that one of her sons is training to be a physician. She said her husband, who she succeeded after his 2009 death, had regularly said that the amount of patients keeps increasing without the number of providers increasing.

“Allow them to practice without being tethered to a physician,” Munoz said of the nurse practitioner bill.

The bill has been endorsed by AARP nationally and is being pressed in state legislatures around the country. Munoz said on the call that 20 states and the District of Columbia currently allow nurse practitioner to practice without the agreement with a doctor.

Munoz noted that there is not much she and others in state government can do to increase Medicare and Medicaid reimbursement rates, noting it is primarily a federal issue. She did note that with the state providing half of Medicaid reimbursements, the state could address that portion.

Munoz, who has regularly promoted the role of nurses in the healthcare process, also used the call to promote a bill she is in the process of crafting that would allow nurse practitioner to sign death certificates. She said that nurse practitioner can declare a patient dead but need a doctor sign the certificate. She said in home deaths where a nurse is providing primary care the nurse should be allowed to sign the form.

She noted that in her study of data about health care access, she said it shows that nurse practitioner are providing the same level or greater care than doctors. Munoz, who did not identify the source of her data, said it shows that the care quality is equal or greater for both physical and psychological care.

Munoz also said that with the greater empowerment of nurse practitioner there would still be regular contact with doctors.

“People don’t understand that every health care professional already collaborates,” Munoz said. “The collaborative relationships will continue. This will allow the nurse practitioner not to sign a contract and having to pay.”