California, New York, Texas, Florida, Illinois, Pennsylvania and Georgia have not enacted the PA Licensure Compact, along with fifteen others. No privilege will ever reach them, and a license held in any of them will not qualify you for privileges elsewhere.
Compact coverage is usually reported as a count of member states, which makes the remainder sound like a rounding error. Measured by practicing PAs it is nothing of the kind.
Which absences matter
Several of the largest markets for physician assistants have not enacted it. That is not an accident of legislative calendars — large states with long-established boards tend to move slowly on compacts, because they have more existing process to reconcile and less to gain from mutual recognition.
The result is a compact that covers a majority of states and a minority of the biggest ones.
If you work in one of them
The compact will not change anything about your licensure unless your state joins. A full application remains the only route in, and your license will not qualify you for privileges anywhere else.
That second half is the one people miss. It is not simply that the compact does not help you where you are; it is that your license does not travel either.
If you work across several states
The compact solves part of the problem and leaves the rest untouched. A multi-state practice including a large non-member market will still be running a full license application there alongside privileges everywhere else.
Which means the administrative burden does not disappear. It shrinks unevenly, and the states that remain are frequently the expensive, slow ones.
The regional clusters that matter
Look at the map by region rather than by count. The tri-state area — New York, New Jersey, Pennsylvania — is entirely outside, which is remarkable given how routinely PAs there work across state lines. A regional practice in that corridor gets nothing from the compact in 2027 and will still be running three full licenses on three unrelated renewal calendars.
The southeast is patchier. Several states have joined and Georgia has not, so portability in the region stops at a specific line rather than fading gradually.
The west has the same shape around California. A PA can build genuine mobility across the interior and still need a full California license for the market that employs the most people.
What to do about it
If your career is likely to include a big non-member state, hold a license there and treat it as permanent — there is no future mechanism that will replace it.
And when 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 from 2027.
Membership moves. Any figure in an article, including this one, is a figure that was true once — the Commission publishes the current list.
Common questions
- Which states are not in the PA compact?
- Twenty-two, including California, New York, Texas, Florida, Illinois, Pennsylvania and Georgia — several of the largest PA employment markets in the country.
- Will a compact privilege let me work in California?
- No. California has not enacted the compact, so no privilege will reach it. A full California license is the only route, now and after privileges open.
- Can a non-member state join later?
- Yes. Membership changes with legislative sessions, and the list has grown from seven states in 2024 to twenty-nine. Check the state page for the date we last verified it.
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