There are two ways to build an interstate licensure compact, and the difference is not cosmetic.
The expedited-licensure model
The Interstate Medical Licensure Compact, which physicians use, does not replace state licenses. It streamlines getting them. A physician obtains a Letter of Qualification once, and member states then issue their own full licenses on the strength of it, quickly and with far less paperwork. At the end the physician holds one license per state, each renewable, each with its own fee.
The privilege model
The Nurse Licensure Compact works differently. A nurse holds one multistate license in their primary state of residence, and that license carries a privilege to practice in the other member states without applying for anything further.
The PA compact follows the second
A PA will hold a license in one member state and obtain privileges in the others. That has three practical consequences.
It should be cheaper. Privileges are generally priced well below full license applications, because the verification work has already been done once.
It concentrates risk. Under the IMLC a physician with six licenses who loses one still has five. Under a privilege model, losing the qualifying license removes everything at once.
It makes residency and license location matter. Privilege models care where your qualifying license sits in a way expedited-licensure models do not. Which state you license in stops being an administrative detail.
None of this is available yet. But the shape is known, and it is worth planning against the right shape.
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