New Poll: Texas Voters Overwhelming Support Removing Barriers on Advanced Practice Registered Nurses

Source: Texas Association of Nurse Anesthetists
Date: March 16, 2023

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Eliminating delegation contract requirement would expand access to healthcare for Texans, particularly in rural and underserved areas hit hardest by growing workforce crisis

Austin, TX (March 15, 2023) – A new statewide poll shows an overwhelming majority of Texas voters support modernizing state regulations on Advanced Practice Registered Nurses (APRNs) to make it easier for patients to see healthcare providers closer to home. The poll was commissioned by Texans for Healthcare Access and conducted in February by Baselice & Associates Inc. and GS Strategy Group.

The poll of 800 likely voters found 90% of Texans believe Texas should make it easier for more patients to get care from APRNs, and 81% support removing the requirement that APRNs obtain an often-costly contract with a physician before they can treat patients. The poll’s margin of error was +/-3.5%.

Texas voters strongly believe patients should be able to choose how, when, and from whom they get their care. Voters say patients face problems such as overstretched providers, extended travel times, and long waits for appointments. They support options like seeing a nurse practitioner for visits and treatment and telehealth to help eliminate barriers like travel and long wait times, and to make it easier for patients to access care.

Findings include:

  • 75% of respondents believe it needs to be easier to access healthcare services in Texas. Voters are concerned about being able to access care when and where they need it.  
  • 82% of respondents say that hospitals, clinics, and medical offices are overwhelmed with the number of people seeking medical care. Voters say this is making it hard for people to get appointments and treatment when they need it.
  • 9 in 10 voters want to make it easier for patients to get care from APRNs and help end the staffing shortage. The survey found 90% of respondents agree that Texas should make it easier for more patients to get care from nurse practitioners and APRNs to help address the shortage of primary care physicians in rural and underserved communities.  
  • 81% of voters support removing the requirement that an ARPN obtain a contracting agreement before they can practice. Support spans political parties with 85% of Democrats, 72% of Independents, and 80% of Republicans supporting the policy. In 2022, the State Republican Party adopted this policy into their platform and the State Democratic Party Convention adopted it as a final resolution.
  • 83% of voters say Texas should remove regulatory barriers to address our workforce shortage and help recruit and retain more APRNs. Texas is competing with other states for the most qualified healthcare providers, but its laws are among the most restrictive.


More than half the states – including Florida, New York, and California – along with all branches of the U.S. Military and the VA have done away with contracting physician requirements and none have changed their mind. This puts Texas at a competitive disadvantage. Data from the growing number of states who have modernized their laws show improved access and continuity of care for patients and reduced administrative costs and burdens. 

Eliminating the requirement would not affect scope of practice. APRNs would continue providing the same services they already do, only without the need for a contract. This would allow APRNs to more easily provide care to Texas patients, especially in rural and underserved areas.

 "We are facing a critical healthcare staff shortage in Texas, especially in rural areas where patients have to choose between waiting weeks to see a provider or leaving their communities to seek care,” said Emily Dove, Policy Advisor for Texas 2036.

“APRNs are highly trained and well-respected healthcare professionals who have garnered the trust of their patients,” said Tom Aldred, Executive Director of Texas Conservative Coalition Research Institute (TCCRI). “Despite decades of data showing their reliability and proven ability to improve patient outcomes, Texas laws remain outdated and anticompetitive. Removing the contracting physician requirement in Texas will enable APRNs to expand access to care and reduce patient costs.”

Senator César Blanco has introduced the HEAL Texans Act, SB 1700, which would eliminate the contracting physician requirement, provide more access and options for Texans who need care, and reflect the will of an overwhelming majority of Texans.


Texans for Healthcare Access is a coalition of organizations representing consumers, business, and a broad range of healthcare stakeholders. These groups have joined forces to remove unnecessary barriers to care and allow Advanced Practice Registered Nurses to provide more access and more options for Texas patients. Learn more here.

Texans for Healthcare Access sponsored opinion research conducted by Baselice & Associates Inc. and GS Strategy Group from February 10-15, 2023. The survey polled a sample size of 800 voters in Texas to understand their opinions on policies that would improve access to care in the state (margin of error is +/-3.5% at the .95 confidence interval).

Texans for Healthcare Access Coalition Members



AARP Texas


Americans for Prosperity - Texas

APRN Alliance

Coalition of Texans with Disabilities

Consortium of Texas Certified Nurse Midwives

Convenient Care Association

Every Texan (formerly Center for Public Policy Priorities)

Leading Age Texas

Methodist Healthcare Ministries of South Texas

National Alliance on Mental Illness (NAMI) Texas

National Council of State Boards of Nursing

Nurses Care Hub

Philippine Nurses Association of America

R Street Institute

Texas 2036

Texans for Affordable Health Care

Texans for Midwifery

Texas Association of Benefit Administrators

Texas Association of Business

Texas Association of Nurse Anesthetists

Texas Association of Health Plans

Texas Association of Health Underwriters

Texas Business Leadership Council

Texas Conservative Coalition Research Institute

Texas Clinical Nurse Specialists

Texas Doctors for Social Responsibility

Texas Employers for Insurance Reform

Texas Impact

Texas Nurses Association

Texas Nursing Legislative Agenda Coalition

Texas Nurse Practitioners

Texas Organization of Rural and Community Hospitals

Texas Physician Assistant Business Alliance of Texas

Texas School Nurses Organization

Texas Silver Haired Legislature

The Heartland Institute

The Libre Initiative

University Health

Veterans Deserve Care

Young Conservatives of Texas