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Which states changed nursing scope-of-practice laws during the Trump administration (2017–2021)?
Executive summary
State-level changes to nursing "scope of practice" (SOP) during 2017–2021 occurred unevenly across the U.S.; several academic studies and policy summaries note that some states loosened NP/APRN restrictions in that window (examples cited include South Dakota, Indiana, and Virginia changing from restricted to conditional in 2017–2018) while many other states did not [1] [2]. National groups tracked a mix of legislative and temporary executive actions around the COVID-19 emergency in 2020–2021 that further altered practice rules in some states [3] [4].
1. What “scope of practice” means — and who changes it
Scope of practice defines what services a licensed nurse or advanced practice registered nurse (APRN) is legally permitted to perform; the rules are set by each state’s “Nurse Practice Act” and interpreted by state boards of nursing [5] [6]. Because NP/APRN rules are state statutes or regulations, changes typically come from state legislatures or regulatory boards — sometimes temporarily by governors’ executive orders in emergencies [5] [3].
2. Academic evidence identifying states that changed SOP in 2017–2018
Researchers who examined prescribing and practice outcomes limited some comparisons to states that enacted statutory changes in 2017–2018. One national study explicitly lists South Dakota, Indiana, and Virginia as states that moved from “restricted” to “conditional” NP authority in 2017–2018; the study used those changes to compare prescribing patterns between 2016 and 2018 [1]. This provides concrete, peer‑reviewed evidence of at least these three state-level changes during the Trump-era years asked about.
3. COVID-era temporary and emergency changes (2020–2021)
During the COVID-19 pandemic, governors and state agencies in multiple states issued emergency orders or waivers that loosened SOP restrictions so NPs/APRNs could practice more autonomously; the literature cites Massachusetts, New York, Pennsylvania, and New Jersey among governors who issued orders to temporarily allow fuller practice authority [3]. Those were often temporary emergency actions rather than permanent statutory rewrites, and some began to expire or be reversed after the emergency [3].
4. How comprehensive the reporting is — important limitations
Comprehensive, state‑by‑state lists of every legislative or regulatory change from 2017–2021 are not provided in the documents in your search results. Several sources note that SOP laws vary widely and that tracking changes is difficult because some actions are statutory, some are regulatory, and some are temporary emergency orders [4] [7]" target="blank" rel="noopener noreferrer">[7]. Therefore, while academic articles name specific examples (e.g., SD, IN, VA) and COVID-era summaries list states with emergency orders, a full authoritative roster of every state that changed SOP in 2017–2021 is not available in the supplied materials [1] [3] [4].
5. Conflicting viewpoints and policy stakes
Advocates (nursing organizations) push for broad "full practice authority" on evidence they say expands access to care, while some analyses suggest outcomes differences are small or mixed; one review found no association between SOP and several measures of care quality in some settings, even as other studies document access and workforce impacts [2] [4]. Policy briefs such as Mercatus argue that easing SOP restrictions can lower costs and expand provider supply, showing the economic vs. professional‑control fault lines in the debate [8].
6. Practical next steps if you need a complete list
Because the available sources here do not publish a comprehensive state-by-state list for 2017–2021, the most reliable next steps are: (a) consult the American Association of Nurse Practitioners’ state charts and legislative trackers for year-by-year changes; (b) review the National Conference of State Legislatures’ Scope of Practice Landscape; and (c) examine state legislative records or boards of nursing for each state of interest. The articles provided highlight specific research examples (SD, IN, VA) and note many COVID emergency orders (MA, NY, PA, NJ) but do not claim to be exhaustive [1] [3] [4].
7. Bottom line for readers
Available reporting in the supplied sources confirms specific statutory changes in South Dakota, Indiana, and Virginia around 2017–2018 and documents multiple temporary COVID‑era executive actions (including Massachusetts, New York, Pennsylvania, New Jersey) that loosened SOP during 2020–2021, but it does not provide a definitive, exhaustive list of every state that changed SOP during the entire 2017–2021 period [1] [3] [4]. If you want a complete roster, the state-by-state trackers maintained by professional organizations and the NCSL are the proper next sources (not in the supplied set).