OpenCampaign

Health and Health Care

Community Voice

Rural healthcare access and CON reform

Tennessee is directing federal Rural Health Transformation Fund resources to rural hospitals, EMS, and primary care while debating scope-of-practice expansions for nurse practitioners and physician assistants plus modernization or elimination of Certificate of Need rules to reduce barriers to care in rural communities.

Should Tennessee expand scope of practice for nurse practitioners and PAs and modernize or eliminate Certificate of Need requirements to improve rural healthcare access?

Tap a point along the line below to show where you stand.

How important is this to you?

Sources

Governor Bill Lee — https://www.tn.gov/governor/news/2026/4/23/gov--lee-marks-the-close-of-the-2026-legislative-session.html
The legislative agenda also prioritized expanding access to healthcare and reducing barriers to care, particularly in rural communities, through scope of practice reforms and Certificate of Need (CON) modernization.
Governor Bill Lee / Baker Donelson summary — https://www.bakerdonelson.com/tennessees-2026-state-of-the-state-address-retrospective-final-year-priorities-and-budget-details
Rural Tennessee is also poised for one of its most consequential legislative sessions in years, driven by the recently awarded $1 billion Rural Health Transformation Fund... the Governor urged lawmakers to consider significant policy reforms including scope of practice adjustments for nurse practitioners and physician assistants and the elimination of the certificate of need process.
Positions on this issue  ·  liberal → conservative
  1. Fully eliminate CON and broadly expand NP/PA independent practice with strong state funding for rural clinics
  2. Modernize CON and meaningfully expand scope of practice while adding patient-safety guardrails
  3. Pursue targeted CON reforms and limited scope expansions only where rural shortages are documented
  4. Keep most CON rules and traditional physician oversight; focus mainly on facility grants instead
  5. Preserve strict CON and physician-led models; oppose scope expansions that could fragment care