Nurse Practitioners and Obamacare: How Will Health Reform Affect Nurse Practitioners?

Two things are certain about health reform:  health reform is controversial and health reform will positively affect the nurse practitioner job market.  With the passage of the Affordable Care Act, nearly 50 million Americans will gain access to healthcare services.  Given the current shortage of primary care physicians, nurse practitioners must be ready to step in and fill in the gap to provide healthcare services to these newly insured patients.

Many Americans have been unable to receive health insurance in the past due to financial constraints or lapses in coverage due to preexisting conditions.  The Affordable Care Act promises to remove these barriers for 50 million Americans allowing them to gain coverage under a health insurance plan.  This influx of new patients into the healthcare system promises to strain the current primary care provider shortage in the U.S.  Teresa Valero of the Mennonite College of Nursing predicts the shortage of primary care providers will be overwhelming stating "the problem is that the number of physicians who choose primary care are decreasing".  Given the primary care shortage, how will 50 million people find healthcare providers?

Nurse Practitioners are the answer to this problem.  Nurse practitioners are able to provide quality primary care services to patients.  In many states, NP's are allowed to practice independently without physician supervision making them even more effective in filling the primary care gap.  Nurse practitioners can also complete their schooling much more quickly than physicians allowing universities to quickly educate students so they can step in to help this problem.  NP's are the obvious solution to the primary care shortage in the U.S. 

If you are considering becoming a nurse practitioner, start now!  With 50 million new Americans soon to be flooding clinics across the nation, we need you!  If you are already a nurse practitioner, Obamacare is good news for you as well.  As demand for nurse practitioners increases, the job market improves with new NP positions opening.  Nurse practitioner salaries will increase as nurse practitioners are increasingly viewed as the solution to the primary care physician shortage.  Bottom-line?  Is you are an NP, health reform is good news.


I am a RN with many years of Flight Nursing, ICU, and ER experience. I have had many experiences with MD's who cannot admit mistakes, take sound medical advice, or be thankful for help in avoiding a medical disaster from someone they feel is INFERIOR. I have rarely had this same experience when working with nurses and nurse practitioners. I currently work in an ICU in a teaching hospital. I have heard attending physicians tell resident physicians that they are treating a patient correctly even when medical errors are made. For example giving adenosine for wide complex tachycardia. Then following up with amiodarone, metoprolol , and cardiazem! I guess to cover all possible tachy arrhythmias. What a joke. This type of incident occurs to frequently . Disdain for nursing, respiratory, and other staff begins in residency . Residency should be an opportunity to train compassionate, competent, and integrated providers. Not a program to further inflate egos. The reality is that no single person can know everything about medicine. Medical professionals should be life long learners and collaborators. Our patients deserve it. Looking forward to starting a DNP program in 2014. Thanks.


I cannot help but hope that NP's are governed more authority in the healthcare arena. I have heard of a new law being looked at that NP's will be able to practice without a sig from a MD for hospice, home health, and skilled nursing. I am an independent practitioner that is the only NP in my city providing house calls to many unfortunate elderly individuals that are unable to leave their homes. I do have an MD sign my skilled nursing but its a sig and is unknown to many of my patients. As far as physiology, pharmacology, and practice...many MD's I practice along are amazed on how much education and interns we have! It is the stubborn and egotistical MD that doesn't want to work alongside and understand why we are a NP. Many patients tell me that I treat the entire problem and come to the core of what is wrong vs. physician telling them to make another appointment and refer for simple matters as they are too busy to deal with during the appt. Maybe "doc" should listen and learn from NP's...see what we do and work with us not against! Modern medicine is allowing MD's to specialize in the medical model! I believe in "Providing the Best Care Possible"...not concentrating on who provides the better care! Move on Doc...


The reimbursement will not got UP, it will go down. Medicare is already 15% less than an MD. An independent NP has to have a sig from an MD f0r hospice, home health and nursing homes. Trust me if you are independent, you're tanked. Obamacare is raising $$$$$ for primary care MD's. Great, if you want another seven or so years of training. I already have 13. Read today's CNN Money. You might want to be near a toilet.

another NP

I can not help to think of all the patients that have had near misses when the PHYSICIANS overlooked what our supposedly "minimal" background in pathophysiology caught! No further comment.


Hi Stephanie,

Fortunately, most experts don't think the DNP rule will take effect by 2015.  They predict it will be much longer before the DNP is actually required so you likely have time to start an NP program before it is required.  So yes, I think the DNP regulation will be delayed. 

Erin Tolbert

Hi Erin, your site is so helpful! I am an RN in home health in NC and could greatly benefit patients with more autonomy that a NP degree would offer, but sadly only recently became aware of the new DNP rule. I have an ADN with a BS in Business, so I have at least a year to complete a BSN. You would think they would relax that rule considering the demand for more NP's?


As long as you have started your NP program by 2015 you will be fine as an MSN under proposed legislation.

Erin Tolbert

I am currently enrolled in a part time ANP program, but I will not be finished until 2016. I plan to go on for a post masters FNP after, will I be grandfathered in under the MSN?

Thank you


I will go for my NP when the paradigm from which we operate changes from a symptom management society to a prevention, keeping people well way of practicing. I like the idea of having both Physicians and NP's. I think Nurses have a lot to offer Doctors and vice versa. Let's be friends and change healthcare in America together. Seriously.


Hi Thanh,

Nope!  As long as you start your program by 2015 you will be able to practice with an MSN.  Also, it doesn't look like the DNP requirement will actually be official by 2015 so even if you are delayed, you will be just fine.

Erin Tolbert