Starting July 15, nurse practitioners in Kentucky who have completed a four-year collaboration with a physician will be allowed to prescribe routine medications without a doctor’s involvement, a major shift that could help improve consumers’ access to care. The law that makes this possible passed after five years of legislative debate. Nurse practitioners are fighting in other states for more authority to treat patients at a time of rising concern over the impact of the federal health law. As more Americans get insurance, there may be shortages of primary care doctors, especially in states like Kentucky that have many rural areas.