The nationwide effort to deal with the coronavirus has brought new attention to the idea of removing government barriers to the employment of medical expertise across state lines.
Reforming state occupational licensing requirements to allow newly arrived licensed workers to ply their trade in their new state streamlines the workforce and increases access to health care by allowing providers to reach consumers more quickly. The overall share of workers required to obtain an occupational license to do their job has soared from about one in 20 to about one in four over the past 60 years, according to a 2017 report by the Institute for Justice.
Workers, including those in the medical profession, frequently find they must apply for a new license upon relocating to a different state. The resulting red tape and expense carry an especially heavy price when health-care professionals are needed to combat a deadly pandemic.
“Licensing recognition makes it easier for people to provide their services across state lines,” said Michael Slabinski, director of the commerce, insurance, and economic development task force at the American Legislative Exchange (ALEC). “It is especially important during COVID-19, as health care workers are needed more in some states than others.”
Model Legislation Available
Model legislation developed by ALEC provides a blueprint states can follow to lift restrictions on cross-border licensing. ALEC’s Model Interstate Mobility and Universal-Recognition Occupational-Licensing Act (the Freedom to Travel and Work Act; see sidebar) is designed to apply to a wide range of professions and could cover physicians and nurses who relocate to a new state.
“States should allow access to trained professionals even if their licenses did not originate within the state,” said Slabinski. “Just because someone crosses state lines does not negate their training and experience. Universal recognition lets workers apply their certification, work experience, and occupational license in good standing towards applying for a license in a new state.”
Calls for Regulatory Review
States should make sure their licensing rules are truly needed, says Slabinski.
“As the number of licensed professionals increases, states should consider a system of licensing review that requires legislatures to periodically review occupational licensing requirements to determine if other forms of regulation, like registration or inspections, are less burdensome and more effective at protecting health and safety.”
Medical professionals and the public at large could benefit from occupational licensing reform, says Rea Hederman, vice president for policy at the Buckeye Institute.
“ALEC’s [model] is meant to apply to a wide range of professions but could also cover physicians and nurses who relocate to a new state,” said Hederman.
Springboard to Telemedicine
Streamlining occupational licensing laws would have a direct effect on the growing field of telemedicine. The COVID-19 crisis created a need to reduce human contact, and for many people this has meant foregoing a trip to the doctor or to a hospital, especially when dealing with illnesses unrelated to COVID-19. Telemedicine can alleviate that problem.
“Technology and the internet have made treating patients remotely a possibility no matter where the provider is located,” said Brooklyn Roberts, director of ALEC’s health and human services task force. “The current pandemic reminds us how important it is to have access to great care in many different forms. Telemedicine can be especially helpful in treating mental health or substance abuse issues, and the importance of allowing access to trained providers regardless of their location should not be overlooked.”
Telemedicine, which already has 20 million users, can help fill that gap, but telehealth providers still face barriers to cross-border licensing. Some states make it difficult for telemedicine by requiring providers to connect patients to licensed physicians within their states, making it more expensive and reducing choice and access. In addition, many people in rural areas still have internet access problems that hinder their ability to use telemedicine.
Bonner R. Cohen, Ph.D., (firstname.lastname@example.org) is a senior fellow at the National Center for Public Policy Research and a senior policy analyst with the Committee for a Constructive Tomorrow (CFACT).
Anna Parson, “State Innovation Index, Telehealth,” American Legislative Exchange Council, 2019: (TBA)
Model Interstate-Mobility and Universal-Recognition Occupational Licensing Act (The Freedom to Travel and Work Act), American Legislative Exchange Council, September 3, 2019: https://www.alec.org/model-policy/model-interstate-mobility-and-universal-recognition-occupational-licensing-act-the-freedom-to-travel-and-work-act/