Nurse practitioners try new tack to expand foothold in primary care

Nurse practitioners say efforts to expand primary care to millions of Americans under the health law are hampered by insurance industry practices that limit or exclude their participation. Despite laws in 17 states and the District of Columbia allowing them to practice independently, nurses with advanced degrees say some insurers still don't accept them into their credentialed networks as primary care providers, while others restrict them mainly to rural areas. After years of fighting doctors in state legislative battles to expand their authority, nurse practitioners are taking a new tack: asking the Obama administration to require insurers to include them in the plans offered to consumers in new online marketplaces, which open for enrollment Oct. 1.