Bill to Law Process

Bill to Law Process


Nurses are very influential in the law making process especially if it deals with health care policy that touches on them. This paper is a description of how this influence can come into play at the State legislation level. The paper will suggest an idea that according to nurses will warrant a change in the law to better the situation (Poghosyan, Boyd, & Knutson, 2014). What will follow is the procedure of making a Bill becomes law in the State. The procedure is similar n majority of the State governments in Texas.


As is known, the State of Texas is one among the remaining States in the United States that is yet to allow the full independent practice to the nurse practitioners in the state. Texas is a big state that is served with both rural and urban populations. The apart from Dallas and Houston much of the remaining Texas is largely a rural community.  Texas is also one among the states that failed to expand their Medicare programs (Poghosyan, Boyd, & Knutson, 2014). The consequence of having large rural communities is that most of the people in Texas end up forming the underserved population. These populations have limited access to quality health care as compared to the urban parts of Texas.

One of the main reasons why these rural communities in Texas are underserved is because there is a real shortage of primary care physicians to serve the residents in the countryside. The qualified primary physicians in the state of Texas are not nearly enough to cover the whole population of Texas. Many people need quality care that the primary care physician is supposed to give, but they cannot access it simply because there are no doctors in the U.S. we then end up with preventable causes of morbidity and mortality in the rural areas (Peck, 2013).

The nurse practitioners in the state of Texas are the best option that can be exploited to cover the shortage of primary care physicians in the countryside. The nurse practitioner is well equipped to offer this service, and it is only the law that hinders their independent practicing status (Peck, 2013). Efforts to change these rules have been blocked by physician organizations in Texas most of which claim they fear for the patient’s safety because they have received more training to take care of patients. Well, research has shown that the level of patient satisfaction among patients who have received care from a nurse practitioner is equal to or in some cases higher than that of patients treated by a physician (Poghosyan, Boyd, & Knutson, 2014). What’s more the patient outcomes for nurse practitioners too have either been equal to or better than those of doctors.

There is, therefore, no reason why physicians should block the independent practice of nurse practitioners considering it is the best way to improve access to the underserved rural populations in Texas (Peck, 2013).

Action plan

After discussing the matter with several other colleagues most of whom are nurses and rural area dwellers in Texas, there was an overwhelmingly mutual feeling that there was a need to change the policy hindering full independence practice by nurse practitioners. The nurses and rural residents feel the people of Texas should not be denied access to equitable and quality health care if there are competent nurse practitioners who could do the same job or even better. There was an agreement to solicit for support from 2000 other nurses and dwellers of the rural areas in Texas then seek the support of a Texas legislator (Sabo:AWS, 2017). The senator would need at least 2000 signatures and names on a worksheet to fill out the legislative sheet.

Within a couple of days, the 2000 signatures and names on a petition are ready and taken to the legislator. The legal worksheet and the petition are presented to the legislator who discusses the potential of the Bill with other lawmakers from the House. The congressman gets two of his colleagues to agree to support the motion to pass the Bill into law. During the next session in the House, the three legislators introduce the Bill to grant Nurse Practitioners with full independence in their practice in Texas to the House and start it on the journey to becoming law (Sabo:AWS, 2017). The committee members dialogue on the advantages of the Bill then go to vote on it. If the Bill is approved, it then passes to the full House. There too its merits will be discussed and weighed, and then another vote will be cast. If the House fails to approve it, it may be abandoned or sent back to the committee. If more than half of the House approve it, it is then forwarded to the Senate (another house) (Sabo:AWS, 2017).

Here, the procedure is repeated if it gets the approval of the House it is sent to the Governor for signing into law. The governor has the power to veto the bill and reverse its path back to Congress. In the two Houses can amend the law to suit the governor, do away with the bill or vote to override the governor’s decision during which they will have to garner a two-thirds majority vote (Sabo:AWS, 2017).


In conclusion, the paper has provided a detailed description of how a bill becomes law using the scenario of Nurse Practitioners seeking full autonomous practice in Texas. Nurses are very influential in the law making process especially if it deals with health care policy that touches on them.




Peck, J. (2013). Addressing the Texas Health Care Crisis: Effective Use of Advanced Practice Registered Nurses. The Journal For Nurse Practitioners9(2), 116-121.

Poghosyan, L., Boyd, D., & Knutson, A. (2014). Nurse Practitioner Role, Independent Practice, and Teamwork in Primary Care. The Journal For Nurse Practitioners10(7), 472-479.

Sabo:AWS, A. (2017). Grand Canyon University | Digital Retrieved 24 February 2017, from