The Post-Gazette editorial "The Doctor Crisis: A Key Bill Counters the Looming Physician Shortage" outlines the predicted increased shortage of doctors as more Americans gain insurance coverage with the Affordable Care Act. The editorial mentions part of the solution could lie in the proposed Training Tomorrow's Doctors Today Act, which would create 15,000 new residency positions over five years.
The editorial also states, "Regulations that allow nurse practitioners, physician assistants and others to use the full range of their training and skills also would help alleviate the burden on primary care doctors." The ACA requires that health plans in the new marketplace of insurance exchanges, as well as employer-sponsored group health plans, provide coverage of and payment for the services of all state-licensed health providers, including free-standing birth centers and midwives. This requirement of "nondiscrimination in health care" is set out in Section 2706 of the ACA. Unfortunately, some attempts are being made to repeal this part of the act or to undermine its implementation.
Certified nurse midwives could play a critical role in addressing the provider shortage as they are recognized as primary care providers under current law. Demand for midwifery care is growing. In order for CNMs to have a significant impact on increasing access to quality, low-cost care, we need to be sure they can practice to the fullest extent of their license and receive fair reimbursement for services provided as well as increase educational programs for becoming a CNM.
The Midwife Center for Birth & Women's Health