There is a crisis in primary health care accessibility in the United States. Many commentators identify a lack of health insurance coverage as a major cause of inadequate health care; however, few acknowledge the impact that a shortage of primary care physicians has on the ability of consumers to receive timely and appropriate primary care, regardless of insurance status. If we improve access to primary care as contemplated by the implementation of the Patient Protection and Affordable Care Act, we must also increase the number of primary care providers. As we learned from Massachusetts, the expansion of health insurance exacerbates the need for primary care providers, and State political will is necessary to ensure providers are available.
Emerging primary care providers, like nurse practitioners—nurses with master’s-level education or beyond—are increasingly filling the gap in the primary care provider workforce. This Article describes the history and development of the role played by autonomous nurse practitioners and urges a critical analysis of barriers that warrant reform in order to promote the growth of an approach to health care that promises to pay substantial dividends in improving the health of our communities. Reducing disparities in access to health care will require more than increasing insurance coverage. It will also require that we increase the number of competent primary health care providers, and nurse practitioners are poised to meet the need.