Michigan lawmakers have reached a bipartisan agreement to renew the state's participation in the Interstate Medical Licensure Compact (IMLC), a program that allows physicians to practice medicine across state lines. Governor Gretchen Whitmer signed House Bill 5455 into law on March 26, just ahead of the March 28 deadline that would have jeopardized the licenses of up to 8,000 Michigan doctors.

The Crisis Averted

Without the compact, approximately 100,000 Michigan residents would have needed to find new physicians, according to estimates from Marschall Smith, executive director of the Interstate Medical Licensure Compact Commission. The compact had been Michigan's home state membership since 2019 and has been used by roughly 8,000 physicians to treat patients in the state.

Dr. Mark Smith, chief medical officer at Michigan State University Health Care, had warned last week that the impact on patients would be significant if the legislation was not passed. "That equates to about 100,000 patient visits a day that this would impact negatively," Smith said, noting that the expiration would have affected patients requiring specialized care, including those who rely on remote radiology services.

How the Compact Works

The Interstate Medical Licensure Compact, which includes 43 states plus Washington D.C. and Guam, streamlines the licensing process for qualified physicians. Instead of waiting months or even years through traditional state-by-state applications, the compact allows expedited licensure in weeks. Approximately 80% of U.S. physicians meet the criteria for licensure through the compact.

Of the 8,000 doctors whose licenses are approved by the compact in Michigan:

  • 5,000 are out-of-state doctors who see Michigan patients, either in-person or by telehealth
  • 3,000 are Michigan doctors who see patients in other states

Dr. Emily Hurst, immediate past president of the Michigan Osteopathic Association, said the state's membership "may not be widely known to the public, but it has become essential to how we deliver healthcare in this state." Hurst, whose own licenses to practice in Michigan pre-date the compact, noted that "if they don't have a license, they cannot practice."

Rural Impact

The compact has been particularly important for rural Michigan communities, where recruiting physicians is already a significant challenge. Rachel Ruddock, director of workforce and career training at the Michigan Primary Care Association, explained that "in many parts of Michigan, the nearest specialist is often several counties or hours away."

Dr. Dorothy Nelder's experience illustrates the compact's importance. Nelder, a family medicine physician who practiced in Georgia for years, moved back to Michigan last year to be closer to family. She began practicing at East Jordan Family Health Center in Antrim and Charlevoix counties, serving 440 active patients and overseeing the care of 1,000 more through a physician assistant and nurse practitioner.

Before Nelder arrived in East Jordan, the clinic sometimes contracted with a doctor in Florida who would fly into Kinross in the Upper Peninsula and travel more than 90 minutes to the clinic to practice for a week at a time. Without the compact, Nelder would have had to wait months to obtain a traditional Michigan license, leaving her 1,000 patients without their primary care physician.

The Political Standoff

The legislation had been stalled for months, with Republican leadership in both chambers blaming Democrats for delaying action. House Speaker Matt Hall (R-Richland Township) previously hinted at a debate about who would get credit for the bill.

However, a bipartisan deal was finally reached on March 19, with the Michigan Senate passing the legislation sponsored by Rep. Rylee Linting (R-Wyandotte) on March 24. The bill passed the House 102-2 and the Senate 36-1, demonstrating overwhelming bipartisan support.

House Speaker Hall announced the deal alongside Linting during a press conference. "This agreement and getting this bill to the finish line will provide clarity and relief for so many people throughout our area and the state," Linting said. "It protects access for our most vulnerable citizens. Doctors who help deliver vital care and better health outcomes for patients won't see interruptions with their licenses."

Senate Majority Leader Winnie Brinks (D-Grand Rapids), whose spokesperson confirmed the deal, noted: "While the House Speaker says we had a 'crisis' on our hands, I want to be clear: this should never have become a crisis. This could have been easily settled months ago with the Senate's bipartisan legislation, but it became clear that the speaker was unwilling to take that path."

Healthcare Industry Reaction

Brian Peters, CEO of the Michigan Health & Hospital Association, thanked lawmakers for reaching the deal. "We're eager to see this important piece of legislation advance to Gov. [Gretchen] Whitmer and look forward to her swift signature," Peters said. "For many hospitals, especially those serving rural or border communities, the compact supports access to care in high-demand specialties such as emergency medicine, psychiatry, obstetrics and primary care."

Peters emphasized that the compact "enhances workforce flexibility and protects access to timely care," noting that hospitals in high-demand specialties would be particularly affected by the compact's renewal.

Healthcare Doesn't Pause for Paperwork

The urgency of the situation was underscored by the fact that healthcare doesn't pause for paperwork. Dr. Hurst noted that on March 29, "those appointments don't happen" unless the compact is renewed. For the thousands of Michigan doctors whose licenses depend on the compact, the difference between having and not having a license is the ability to practice medicine and serve their patients.

The traditional process of applying for a Michigan medical license can take months, starting with fingerprinting and moving through various administrative steps. Dr. Nelder, who began the process of applying for a traditional Michigan license the day she discovered the compact had not been renewed, found herself waiting weeks for confirmation that her fingerprints had been processed, with no indication of when she would be able to move to the next step.

Looking Ahead

With Governor Whitmer's signature on March 26, the legislation has become Public Act 6 of 2026, ensuring Michigan's continued participation in the Interstate Medical Licensure Compact without interruption. The compact remains a critical tool for addressing Michigan's physician shortage, particularly in rural and underserved communities.

As Michigan faces ongoing challenges with physician availability and healthcare access, the compact provides a streamlined pathway for qualified physicians to practice in the state, benefiting both doctors and the patients they serve.

Sources

  • WZZM 13: https://www.wzzm13.com/article/news/politics/michigan-politics/whitmer-signs-bills-into-law/69-d5b96121-ccc3-432c-b786-caec8ab651b7
  • WWMT: https://wwmt.com/news/local/michigan-doctors-physicians-health-interstate-medical-licensure-license-hospital-patients-lawmakers-legislature-politics
  • MLive: https://mlive.com/politics/2026/03/100000-michiganders-wont-lose-doctors-lawmakers-say-with-deal-on-interstate-compact.html
  • Michigan Health & Hospital Association: https://www.mha.org/newsroom/governor-whitmer-signs-interstate-medical-licensure-compact-bill/
  • Bridge Michigan: https://bridgemi.com/michigan-health-watch/lansing-gridlock-jeopardizes-licenses-for-8k-michigan-doctors
  • MHA Monday Report: https://www.mha.org/newsroom/imlc-bill-protects-healthcare-access/

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Michigan lawmakers reached a bipartisan deal to renew the Interstate Medical Licensure Compact, signed by Governor Whitmer just before the March 28 deadline that would have affected 8,000 doctors and 100,000 patients.