The National Association of Pediatric Nurse Practitioners (NAPNAP) has released an updated position statement on access to care, including children who live in poverty who are more likely to be uninsured. These children have worse “health status, delayed immunizations, and higher odds of emergency department visits,” according to the statement released in the Journal of Pediatric Health Care.1 

NAPNAP recognizes “the critical role that pediatric nurse practitioners (PNPs) and other health care providers play in ensuring that all children have equitable access to high-quality health care,” To remove barriers that may limit families and children from receiving comprehensive, continuous, and coordinated health care, “NAPNAP continues to advocate for access to in-person and telehealth services and emphasize the importance of a primary health care model, which encourages lifelong and thorough access to care.” 

In the statement, NAPNAP notes access to universal health care insurance is crucial for improving children’s health care. After reaching a historic low in 2016, the rate of uninsured children has risen. In 2020, the number of uninsured children has risen to 4.3 million, or 5.6% of all children.  “In 2020, 54% of children had private insurance and 42.2% were enrolled in a public health plan,” said NAPNAP.

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Programs such as Medicaid and the Children’s Health Insurance Program (CHIP) were developed to provide health insurance and high-quality primary health care from a usual source of care for eligible children. Therefore, reauthorization of health coverage through Medicaid and CHIP is “essential to ensuring vulnerable children access to health care,” they added.

“By advocating for the expansion of insurance coverage, pediatric-focused advanced practice registered nurses (APRNs) can help ensure that all children have access to high-quality, evidence-based pediatric health care regardless of their socioeconomic background, race, citizenship status or other factors,” said NAPNAP President Jennifer Sonney, PhD, APRN, PPCNP-BC, FAANP.

Supporting health insurance coverage for all children is only one step towards improving care for children. Lack of providers is another barrier. The number of primary care physicians (PCPs) is projected to decline, leaving 37 states with shortage of PCPs by 2025, said the statement. “The limited number of pediatric providers and the inadequacy of pediatric provider networks will continue to limit the care of many American children,” NAPNAP said.

To tackle the lack of pediatric providers, NAPNAP supports legislation that would remove of regulatory barriers to APRN practice such as:

  • Lack of equitable reimbursement
  • Requirements for physician supervision of APRNs
  • Exclusion of pediatric providers from the provider network

NAPNAP also supports the National Academy of Medicine’s recommendations, including full practice authority for APRNs, supporting nurses in achieving higher education, as well as becoming full partners with physicians and other health care professionals, and expanding nurse leadership positions through increased appointments to key decision making and board positions.

To improve health, NAPNAP also supports the Healthy People 2030 objectives that ensure people obtain timely and high-quality health care services. “This can be achieved through supporting growth in community organizations by providing prevention services, increasing the proportion of children and adolescents with health insurance, and reducing the number of people who cannot receive medical care or prescription medications when needed. These, along with other recommendations, can help to optimize child and family health,” concluded the statement.

The organization also endorses the promotion of pediatric data desegregation to highlight disparities in health outcomes and promote targeted interventions as well as supports diversity, equity, and inclusion in nursing and APRN training, education, scholarship, and employment.


1. McRae EM, Lee A, Key SM, McNamara Mt; National Association of Pediatric Nurse Practitioners, Professional Issue Committee. NAPNAP position statement on access to care. J Ped Heal Care. 2022;36(4):388-391. Doi:10.1016/j.pedhc.2022.04.006