Nurse practitioners are highly successful and well received front line primary care providers throughout the US. They have advanced education to provide essential services to patients--many of whom receive Medicare and Medicaid. They make unique contributions through a focus on disease prevention, patient advocacy, and patient teaching.
State regulations determines what a NP can and cannot do in caring for patients. This makes for tremendous variability and allows physician opposition in some states to limit NP practice.
Federal legislation to specify key things that NPs can and cannot do would solve of this state-initiated quagmire and allow NPs to deliver the PCP services under the ACA they are now often limited from providing even though they are educationally prepared to do so.