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Research ArticleArticles

Occupational Licensing and the Healthcare Labor Market

View ORCID ProfileMarcus Dillender, View ORCID ProfileAnthony T. Lo Sasso, View ORCID ProfileBrian J. Phelan and View ORCID ProfileMichael Richards
Journal of Human Resources, May 2026, 61 (3) 1004-1039; DOI: https://doi.org/10.3368/jhr.0722-12450R2
Marcus Dillender
Marcus Dillender is Assistant Professor in the Department of Medicine, Health, and Society, Vanderbilt University, Nashville, TN and a Faculty Research Fellow at the National Bureau of Economic Research.
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  • ORCID record for Marcus Dillender
Anthony T. Lo Sasso
Anthony T. Lo Sasso is the Robert F. and Sylvia T. Wagner Professor of Public Affairs at the La Follette School of Public Affairs at the University of Wisconsin, Madison (corresponding author, ).
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  • For correspondence: tony.losasso{at}wisc.edu
Brian J. Phelan
Brian J. Phelan is Associate Professor in the Economics Department, DePaul University, Chicago, IL.
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Michael Richards
Michael Richards is Professor in the School of Public Policy, Cornell University, Ithaca, NY.
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Abstract

We examine the labor market impact of states easing occupational license requirements by expanding the scope of practice (SOP) for nurse practitioners (NPs), allowing them to practice without physician oversight. Using data on job postings, we find that employers increase their demand for NPs when states expand NP SOP. We then show that SOP laws also increase NP earnings and reallocate NPs across the healthcare sector, including increasing self-employment. The laws only mildly increase employment, however. Therefore, expanding NP SOP has the potential to increase access to primary care, but inelastic NP labor supply has largely prevented this from occurring.

JEL Classification:
  • I11 and J22
  • Received July 2022.
  • Accepted December 2023.
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Journal of Human Resources: 61 (3)
Journal of Human Resources
Vol. 61, Issue 3
1 May 2026
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Occupational Licensing and the Healthcare Labor Market
Marcus Dillender, Anthony T. Lo Sasso, Brian J. Phelan, Michael Richards
Journal of Human Resources May 2026, 61 (3) 1004-1039; DOI: 10.3368/jhr.0722-12450R2

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Occupational Licensing and the Healthcare Labor Market
Marcus Dillender, Anthony T. Lo Sasso, Brian J. Phelan, Michael Richards
Journal of Human Resources May 2026, 61 (3) 1004-1039; DOI: 10.3368/jhr.0722-12450R2
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  • Article
    • Abstract
    • I. Introduction
    • II. Scope of Practice Laws for Nurse Practitioners
    • III. Theoretical Model
    • IV. Data
    • V. Empirical Methodology
    • VI. Results
    • VII. Disentangling Supply and Demand
    • VIII. Conclusion
    • Acknowledgments
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Keywords

  • I11 and J22
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