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How have state responses and legislation changed nurse licensure reciprocity since the Trump-era orders?
Executive summary
State responses and legislation since the Trump-era emergency orders have trended toward formalizing multistate nurse mobility through the Nurse Licensure Compact (NLC/eNLC) and state-level reciprocity rules: by mid–2025 most reporting shows the compact expanded to roughly 39–43 participating jurisdictions, with states like Pennsylvania implementing the NLC in 2025 [1] [2] [3]. Reporting also shows continuing state-by-state variation — some states adopt the compact or fee/expedited reciprocity, while other states and unions oppose compact membership or limit who may use multistate privileges [4] [5].
1. Compact growth: from emergency flex to statutory multistate licensure
During and after the pandemic-era emergency flexibility that loosened cross‑state practice, many states moved to codify broader mobility through the enhanced Nurse Licensure Compact (eNLC/NLC). Multiple outlets show the compact’s rapid expansion into dozens of jurisdictions by 2025 — sources list 39 member states as of mid‑2025 and as many as 43 jurisdictions by October 2025 [1] [2]. Pennsylvania’s full implementation on July 7, 2025, is an example of this legislative follow‑through [3].
2. What the compact actually changes for reciprocity
The NLC creates a single “multistate” license for qualifying RNs and LPNs that lets a nurse licensed in a compact member “home state” practice in other member “remote states” without new licensure, effectively formalizing reciprocity among participants [4]. The compact requires uniform eligibility standards; nurses retain only one compact-state license and must change it if they move primary residence to another compact state [4].
3. State-level variations and continued traditional reciprocity routes
Not all mobility is through the compact. Where a state is not a compact member or for nurses who don’t meet compact uniform requirements, licensure by endorsement/reciprocity processes remain in place; states like Massachusetts maintain expedited reciprocity pathways for outbreak or public‑health responses [6]. State boards continue to publish distinct endorsement rules, and some states require extra verification steps or documentation when Nursys participation is lacking [7] [8].
4. Who is included — and who is not
The eNLC/NLC explicitly covers RNs and LPNs/LVNs; advanced practice registered nurses (APRNs) historically have not been included in NLC reciprocity, prompting separate legislative pushes such as proposed APRN compacts [9] [5]. Maryland and other states are pursuing targeted reciprocity or reporting processes for advanced practice licensure and specialty certification, indicating a piecemeal approach to APRN mobility [10].
5. Political and labor pushback shapes state choices
Legislative action has been contested in some states. Reporting notes union opposition in jurisdictions like New York where unions argued joining the compact could lower standards and undermine collective bargaining, and some legislatures have rejected compact proposals despite executive support [4]. Nurse‑union and labor perspectives have influenced the pace and shape of state adoption [5] [4].
6. Practical effects for nurses and employers
For nurses in compact states, the shift reduces administrative barriers for travel nursing and cross‑state practice; several industry guides and employers highlight improved mobility for disaster response and staffing [1] [11]. For employers and state boards, compact expansion means relying on the NCSBN/Nursys infrastructure for verification, but states maintain distinct fees, timelines, and implementation requirements [8] [3].
7. Legislative trends and next fronts
Recent state bills and enacted laws in 2024–2025 show two simultaneous trends: [12] more states formally enacting NLC membership or related mobility measures (examples include Pennsylvania and multiple other enactments listed in 2025 rollups), and [13] targeted state legislation addressing APRN compacts, fee waivers for new graduates, reserve licenses for retirees, and reporting requirements for advanced practice reciprocity discussions [3] [5] [10].
8. Limitations of available reporting and open questions
Available sources focus on NLC expansion, state implementations, and headline legislative fights but do not provide a systematic before‑and‑after legal comparison tied specifically to “Trump‑era orders.” Reporting here does not mention federal-level revocations or a single uniform national rollback; instead, state statutes and compact adoptions are the documented mechanisms changing reciprocity (not found in current reporting). The sources also do not provide a comprehensive list of every state that changed endorsement rules post‑2020; readers should consult individual state boards for specific, current endorsement procedures and whether APRN reciprocity was legislated locally [7] [6].
If you want, I can compile a state‑by‑state table of which jurisdictions have enacted the eNLC/NLC (and the dates cited in these sources) and list where APRN‑specific reciprocity bills are pending or enacted based on the same reporting.