The Problem
Healthcare supply is needlessly limited by regulations that often protect incumbent providers at the expense of patients.
The Solution
Enact free-market reforms to increase the availability of care across the state while also working to lower healthcare prices.
Key Facts
- Missouri needlessly restricts many medical professionals’ scopes of practice and has complex licensing requirements that reduce healthcare access.
- During the COVID-19 pandemic, Missouri was a national leader in waiving laws and regulations that placed unnecessary limits on healthcare access.
Remove Unnecessary Barriers
“Scope of practice” defines what medical professionals can do in a state, given their training. More treatment options for patients means more competition among providers, which is good for consumers in terms of service and price. This is especially true and important in rural areas where doctors may not always be available or nearby. While Missouri has made some incremental progress on broadening the scope of practice for nurses in recent years, the state still has more restrictive laws than most of the country.
“Telemedicine” is the provision of medical care over the telephone and the internet. For the sake of public health and because many patients felt more comfortable staying at home during the pandemic, Missouri temporarily loosened the regulations that govern who could see a physician online and under what circumstances. Despite the recent expansion of Missouri’s telemedicine laws to include audio-only technologies, there is still work to be done to safely expand telemedicine.
“Licensure” is the manner in which the state regulates certain professions. Unfortunately, licensure can often act as a barrier to entry, especially for qualified healthcare providers from other states. While Missouri’s passage of universal license reciprocity in 2020 was a step in the right direction, the state’s licensing laws are still unnecessarily limiting the number of qualified and willing providers who could otherwise be treating Missouri patients.
Repeal Certificate of Need
Missouri’s Certificate of Need law restricts healthcare competition by requiring many healthcare providers to get state approval before entering new markets or expanding services offered in existing facilities. This restriction hampers market newcomers and puts upward pressure on healthcare prices by restricting supply.
Retake a Top Spot
At the start of the COVID-19 pandemic, Missouri quickly became a national leader in expanding healthcare access. Governor Parson waived numerous laws and regulations regarding scope of practice, license reciprocity, telemedicine, and even Certificate of Need requirements. But in the years since, the waivers were allowed to expire, and Missouri’s legislature has taken minimal action to address the issue.
Missouri’s laws and regulations that specify what the state’s providers are allowed to do and where they can practice play a key role in the recruitment of new state residents and workers. Greater freedom for providers makes job opportunities in a state more desirable for prospective employees. If Missouri’s elected officials are serious about addressing the state’s healthcare access issues, making healthcare employment in Missouri more competitive is required.
Policy Recommendations
- Remove the unnecessary barriers to healthcare access that were previously waived during the COVID-19 pandemic, such as expanded providers’ scope of practice.
- Remove the statutory delays to reciprocity licensure and create additional pathways for licensed healthcare providers in other states to treat patients in Missouri.
- Repeal Missouri’s Certificate of Need laws.
