Compact coverage is usually presented as a count of member states, which makes the remainder sound like a rounding error. By population of practicing PAs it is nothing of the kind.
The absences that matter
Several of the largest markets for physician assistants have not enacted the compact. That is not a coincidence of legislative calendars — large states with well-established boards tend to move slowly on compacts, because they have more existing process to reconcile and less to gain from mutual recognition.
What it means in practice
For a PA who works in one of them, the compact will not change anything about their licensure, ever, unless their state joins. A full application remains the only route in, and their license will not qualify them for privileges elsewhere.
For a PA who works across several states, it means the compact solves part of the problem and leaves the rest exactly as it is. A multi-state practice that includes a large non-member market will still be running a full license application for that market alongside privileges everywhere else.
The planning consequence
If your career is likely to include one of the big non-member states, hold a license there and treat it as permanent. And if you are choosing where to add a second license, a member state is worth more than a non-member state of equal convenience, because it does double duty later.
Membership changes with legislative sessions. Check the state page for the date we last verified it rather than relying on a figure in an article.
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