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Rep. Dave Prestin introduces bill to “cut red tape” for patients in need of healthcare across state lines

by Lily Simmons
April 8, 2025 - Updated on April 9, 2025
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IRON MOUNTAIN, Mich. (WZMQ) – Republican State House 108th District Representative Dave Prestin has introduced a bill that he says will cut through some of the “red tape” associated with healthcare between states.

If passed, House Bill 4309 would see Michigan join the Physician Assistance (PA) Licensure Compact, which enables PAs to care for patients across state lines.

“The compact removes a lot of the bureaucratic barriers that Michigan is notorious for across different licensures,” Prestin said. “Continuity of care with patients can’t be understated. When patients bounce between provider and provider, that continuity is lost every time that patient handoff occurs.”

On Tuesday, Prestin held a press conference at the Marshfield Medical Center in Iron Mountain. He was joined by U.P. healthcare providers, who say they have seen that continuity break down, even for patients spending a period of time just across the Wisconsin border.

“Just an example that I think happens quite frequently—your primary care provider in a rural area is a physician assistant,” said Jodi McCollum, a PA at UPHS – Marquette. “You have a chronic condition that intermittently causes you to have low blood counts. You are going to Wisconsin for the holidays or you’re going to Wisconsin to take care of your mom who just fell and broke her hip… You’re concerned that potentially your chronic illness is flaring… Because you’re in Wisconsin, I’ve got to tell you to go to the emergency department, which is potentially going to increase the amount of patients in our emergency department, which across the country are just inundated with patients. There’s people that are coughing, and you’re potentially exposed to other illnesses when you’re in that emergency department.”

Marshfield PA Korby Howell, who practices in family medicine, added, “Our patients oftentimes do call us requiring care when they are out of town… Practicing just a few miles from Wisconsin can be difficult if I have patients that are simply on a spring break vacation… I have to send them to an urgent care because I’m not able to provide services via telehealth for them.”

Presin says the PA Licensure Compact will make healthcare more accessible for those patients.

“So far, the compact has really had nothing but positives attributed to it, in its ability to move workforce and move capacity throughout the system, you know, relatively seamlessly,” he said.

To date, just over a dozen states have joined the PA Licensure Compact, including Michigan neighbors Wisconsin and Ohio. McCollum and other PAs say the compact improves access to labs, tests, and prescriptions, lessens the impact of staffing shortages, and reduces costs for providers.

“Myself, as a paramedic, I have to hold a license both in Wisconsin and in Michigan,” said Prestin. “… This is going to build capacity. No doubt in my mind.”

The bill is co-sponsored by fellow U.P. Republican Representative Karl Bohnak.

“We need to make sure that this border is not a barrier to good healthcare across our area, all the way from Norway to Vulcan and Loretto, all the way to Waucedah, and the entire county,” Bohnak said.

According to Prestin, the bill has received bipartisan support.

“Allowing physician assistants to practice across the state lines via the compact will bring more providers to underserved communities,” he said. “I’m really thrilled to see this in committee, see it get through, and see it get signed into law.”

In the future, Prestin says his constituents can expect to see more legislation from his office aimed at “breaking down barriers” to healthcare.

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