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Did the Trump administration issue any executive orders affecting nursing licensure or scope of practice?
Executive summary
The Trump administration did issue executive orders and related federal actions that instructed agencies to examine and loosen federal rules affecting advanced practice nurses (APRN) and Medicare participation—most notably Section 5 of Executive Order 13890 on “Protecting and Improving Medicare for Our Nation’s Seniors,” which called for removing “unnecessary and burdensome physician supervision requirements” for APRNs and PAs and directed regulatory review [1] [2]. Separate White House deregulation orders and trackers show a broader push to reduce federal regulation and pause/new-rule reviews that could affect licensure-related federal requirements [3] [4].
1. Executive orders explicitly tasked federal agencies to review APRN supervision and Medicare rules
Advocates and nursing groups pointed to Section 5 of EO 13890 as directly addressing APRNs: it directed the administration to target physician supervision and Medicare conditions of participation that limit clinicians from “practicing at the top of their profession,” and signaled potential federal regulatory changes to how APRNs and PAs participate in Medicare (American Association of Colleges of Nursing letter referencing EO 13890 and commentary from Capitol Beat summarizing Section 5) [1] [2].
2. Federal action did not — and cannot — directly override state licensure laws
Multiple commentaries about the EO and subsequent guidance make clear that professional licensure is primarily a state responsibility; the executive orders can reshape federal program rules (Medicare reimbursement, conditions of participation), but they cannot directly rewrite state nurse practice acts that define licensure and full scope of practice (Capitol Beat’s explanation that changes would be implemented through the federal regulatory process, and multiple nursing organizations noting state-level control) [2] [5]. Available sources do not claim the administration abolished or replaced state nursing licenses; they describe federal regulatory levers only (not found in current reporting).
3. Federal levers targeted Medicare policy, supervision requirements, and regulatory pauses
The administration used broad deregulatory EOs—such as a deregulation initiative requiring cuts for new rules and a rule freeze until newly confirmed agency heads review them—which created space to revise Medicare conditions and other federal rules that touch how APRNs practice within federal programs like Medicare and Medicare Advantage (White House fact sheet on the 10-to-1 deregulation initiative and coverage of the rule freeze) [3] [4].
4. Nursing groups framed the EOs as potentially beneficial but limited in scope
Organizations such as the American Nurses Association and state APRN coalitions praised or cautiously welcomed the direction—celebrating attention to removing “burdensome” supervision requirements and to aligning Medicare reimbursement with time spent with clinicians—while warning implementation would be done through rulemaking and that state law and opposition from other medical stakeholders could limit outcomes (ANA/AACN praise in letters and state APRN advocacy analyses) [1] [6] [2].
5. Implementation matters: rulemaking, agency guidance, and opposition were expected
Analysts noted that the EO’s substantive effects depended on HHS and CMS issuing regulations or guidance, and that federal changes could be constrained by legal, administrative, and political pushback; the Florida APRN advocacy site and Capitol Beat explained that recommendations from HHS would need regulatory action and that state licensure and medical-industry resistance remained obstacles [6] [2].
6. Related federal moves changed higher-education definitions affecting nursing students
Separate Department of Education policy changes under the administration removed nursing from a list of “professional degrees” for certain loan/eligibility rules—an education-policy move affecting funding for nursing education rather than licensure or clinical scope directly—prompting public criticism from nursing groups about downstream workforce impacts (Newsweek, Nurse.org, and related trackers reporting the Department of Education reclassification and ANA responses) [7] [8] [9].
7. What the record does and does not show — concise takeaways
The record in these sources shows executive orders that directed federal agencies to review and recommend reducing federal supervision and Medicare conditions that affect APRNs, and an administration-wide deregulatory agenda that could touch licensure-related federal rules [1] [3]. The sources do not show an executive order that abolished state licensure regimes or that unilaterally expanded APRN scope of practice across states; available sources stress subsequent rulemaking and state-level control [2] [5].
8. How to follow up and what to watch next
To assess concrete changes, watch HHS and CMS rulemaking dockets and Federal Register notices implementing Section 5 recommendations; legal analyses and state nursing board actions will indicate whether federal moves translate into practical scope-of-practice changes. Executive-order trackers and law-firm summaries maintained contemporaneously documented the administration’s many healthcare EOs and can help track which EOs produced formal regulations (Holland & Knight and McDermott trackers; Federal Register EO listings) [10] [11] [12].