New Jersey’s health care system is stretched to its limits. Just ask our patients. They feel it every day.
Nearly 14.5% of adults in New Jersey cannot find a primary care provider. In counties like Salem, a single clinician is responsible for more than 4,000 residents.
Mental health access is even worse.
Many counties have provider-to-patient ratios that double the national average. Overall, health care costs have increased by 50% in less than a decade, while access to essential services continues to slip through our fingers like sand. And with looming federal funding cuts threatening residency programs and public clinics, the problem will only worsen.
So why, in the middle of a nursing shortage, are we still limiting the practice authority of nurse practitioners despite overwhelming evidence of their clinical excellence, safety and fiscal value?
In New Jersey, nurse practitioners, also known as advanced practice nurses, do not have full practice authority. They are legally required to have a collaborating agreement or contract with a physician to prescribe medication or medical equipment such as walkers and wheelchairs.
It’s an outdated and unnecessary barrier that 27 other states have already eliminated.
No wonder so many of our NPs travel across state lines, paying tolls and congestion pricing, to practice without needless restrictions.
What’s more, we’ve already loosened these rules.
And it worked when we did it.
During the COVID-19 pandemic, Gov. Phil Murphy signed Executive Order 112, which allowed nurse practitioners to practice independently. It has been that way ever since.
That’s five, almost six years, with no issues reported, just improved patient care.
Just look at our rankings.
Between 2020-24, New Jersey consistently ranked among the top tier nationally for key mental-health indicators, including lower rates of suicidal ideation and depression compared with much of the country.
During the same period, access to psychiatric and primary-care nurse practitioners expanded mental-health services into communities that had long struggled to find care. More residents received early intervention and follow-up support, helping prevent crises, reduce hospitalizations, and keep patients healthier at home.
These outcomes reflect what happens when nurse practitioners are empowered to practice fully: patients gain access, communities gain stability, and the entire healthcare system becomes stronger and more sustainable.
It’s time to make these gains permanent by passing S1983/A944, state legislation that would finally grant full practice authority to nurse practitioners. Under this bill, new nurse practitioners would require a collaborating agreement with a physician or experienced advanced practice nurse for their first two years before practicing independently. It’s a balanced approach that safeguards patients while expanding access to care. It also unlocks the full potential of New Jersey’s 17,000 nurse practitioners to help close dangerous care gaps, lower costs and strengthen our entire healthcare system.
This proposed legislation is not a turf war between physicians and nurse practitioners. It is a shared responsibility to ensure a sustainable healthcare model. Physicians alone cannot meet today’s demands. There aren’t enough of them. They need nursing practitioners to step in and help.
They’re ready and eager to do so.
And get this: Despite their extensive training and strong track record in patient care, nurse practitioners are reimbursed 15% less than physicians under Medicare and Medicaid for delivering the very same services. Restricting their practice is like buying the latest smartphone and using it only to play solitaire.
It can do so much more.
So can our nurse practitioners.
Research from states with full practice authority consistently shows that nurse practitioners deliver safe, comprehensive, and cost-effective healthcare services. So why continue to hold them back in New Jersey with outdated billing structures and collaboration fees?
Especially when the public is already on board. A recent survey by the New Jersey Collaborating Center for Nursing (NJCCN) found that 81% of respondents agreed that “hospitals, clinics and medical offices are overwhelmed with the number of people seeking medical care.”
The solution?
About 85% said “nurse practitioners and advanced-practice nurses can help.”
They’re right.
New Jersey doesn’t need more red tape. It requires more boots on the ground and more nurses caring for our patients.
Removing unnecessary practice restrictions is fiscally responsible, clinically sound, and proven effective.
It’s also urgently needed.
The New Jersey State Nurses Association looks forward to working with the state’s incoming administration to address this concern. Together, we will craft policies that strengthen the health care workforce, expand access, and ensure every community, from our smallest towns to our largest cities, gets the care it needs.
To do that, we need to stop holding our nurse practitioners back. Let them do what they are trained, educated, and fully licensed to do: take care of us.
When it comes to health care, New Jersey shouldn’t be navigating a maze. Not when a clear, evidence-based and cost-saving path is right in front of us.
Judy Schmidt is the CEO of the New Jersey State Nurses Association.
