HB 3129: Physician Assistant Licensure Compact
Sponsor: Ben Keathley
OPPOSE
Structural accountability concerns.
HB 3129 would plug Missouri into a multi-state "Physician Assistant Licensure Compact," letting a PA licensed in one participating state obtain a "compact privilege" to practice in other participating states without a full Missouri license. While framed as "access to care," it requires Missouri to surrender regulatory authority to an unelected interstate Commission with rulemaking power that carries the force of law.
What Does This Bill Do?
- Surrenders State Sovereignty: Commits Missouri to binding rules issued by an interstate "Compact Commission" that bypass normal state administrative safeguards and legislative oversight.
- Expands Data Surveillance: Requires participation in a national data system to share "significant investigative information," adverse actions, and unique identifiers of professionals.
- Out-of-State Enforcement: Allows Missouri to be sued in federal courts outside the state (D.C. or Commission HQ) for disputes regarding compact implementation or interpretation.
Constitutional or Critical Context
This bill delegates major governing authority to an unelected interstate commission that can promulgate binding rules, set fees, hire staff, and even borrow money. By explicitly stating that "No Participating State’s rulemaking requirements shall apply," HB 3129 creates a direct accountability bypass, functionally sidelining Missouri's constitutional safeguards. Furthermore, the embedding of private national PA organizations as ex-officio members in governance centralizes policy-making upward, away from Missouri voters.
Stop the Mission Creep
National compacts often start as simple "portability" measures but evolve into permanent control architectures. For more information on why Act for Missouri opposes the compact model:
Learn more about the problems with National Compacts →Red Flags & Recommended Amendments
Accountability Bypass
The Commission's "Rules with force of law" override Missouri's normal administrative protections and legislative oversight (§334.1840).
National Data Regime
The bill mandates a centralized multi-state data system with investigative flags and unique identifiers, creating a permanent professional tracking system (§334.1835).
Act for Missouri Recommendation:
Act for Missouri OPPOSES HB 3129. This bill is too structurally committed to the flawed compact model to fix through amendment. Any potential access-to-care gains are far outweighed by the expansion of unelected government, loss of state sovereignty, and exposure to out-of-state litigation.