As summarized by Mackinac Center, the purpose of the bill is “to revise the ‘scope of practice’ allowed for Advanced Practice Registered Nurse (sic), making it possible for them to provide more medical services without being under the direct supervision of a physician.”

Bill language also doubles Registered Nurses’ licensure renewal fees in this legislation sponsored by State Rep. Ken Yonker, R-Caledonia.

“This is the part of the agency budget that has consistently been running in the red,” says a source within the capitol. “LARA [Licensing and Regulatory Administration] wants this increase so that RN fees pay for the program, so it’s self-sustaining. All the nurses organizations are for this bill.”

“Not this one,” says Abigail Nobel, health policy nurse and citizen activist. “I strongly object to the RN fee increase.” She cites the addition to anti-market pressures of Obamacare, which have driven many health professionals from practice and increased healthcare prices.

License Fee as Tax on Nurses

“LARA adds zero value to care here: this is nothing more than doubling down on a tax. If anything, license fees should be reduced to encourage more nurses to practice in Michigan,” Nobel states. “Everyone’s budget is tight. Government agencies like LARA should be looking for ways to cut spending, as Michigan taxpayers have been forced to do.”

Michigan has seen the numbers of actively-practicing RNs drop by almost 14% since 2012. RN license holders must renew every two years. Since 1989, the RN renewal fee has tripled to the current level of $60. HB 5400 doubles this to $120. This levy increase upon RNs in Michigan will gain LARA over $7 Million in revenue, assuming HB 5400 passes with the fee provision intact.

The Real Cost is Patient Access to Care

Nobel, a bachelors-prepared nurse with a Masters in Politics from Hillsdale, supports the stated purpose of the bill. “APRNs are long overdue for Michigan law to allow them to function to the. level of their educational and training,” she maintains. “Expanded scope of practice also improves access to care for the public, especially if Nurse Practitioners were allowed to run a real business for profit.”

But for the greater good in Michigan’s healthcare market, she does call for the RN fee provision to be pulled from the bill. “Expanding practice for specialized nurses does not justify increased fees for over 100,000 working RNs. The state is taking with one hand, while it gives with the other. Lansing needs to hear from all of Michigan on this.”