A new report from the Paragon Health Institute is sounding the alarm for Texas policymakers. The analysis spotlights the $50 billion Rural Health Transformation Program (RHTP)—created under the One Big Beautiful Bill Act (OBBBA)—and makes one message clear: states that remove outdated workforce barriers and allow nurse practitioners (NPs) to practice to the top of their license will have the advantage.
The report urges states to learn from past mistakes that sent rural health dollars to large urban systems and instead direct funds to local, sustainable care models—including NP-led clinics and rural hospitals that are delivering results where they’re needed most.
Among Paragon’s top recommendations:
- Allow full practice authority for NPs and other healthcare providers
- Eliminate anti-competitive regulations
- Expand telehealth; and
- Strengthen rural training pipelines
CMS has already stated it will prioritize states that allow providers to practice to the “top of their license” in awarding federal funds. That means Texas could lose out on millions if lawmakers fail to modernize practice laws and fully leverage the NP workforce to expand access.
As Texas agencies and legislators prepare proposals for RHTP funding, the path forward is clear: to compete for federal dollars and close rural care gaps, Texas must finally remove barriers and let NPs do the work they’re licensed and trained to do.
