From a growing array of policies cutting down on anesthesia reimbursements to federal policies limiting student loans, the anesthesia workforce faces numerous disruptions in an already strained specialty.
Facilities reporting anesthesia shortages rose from 35% in 2020 to 78% by late 2022, and nearly 22% of anesthesia providers are projected to leave the workforce by 2033.
Here are five disruptions to the anesthesia workforce in 2026:
1. Noncompetes and their impact on a strained workforce: A Texas appeals court recently upheld a non-compete injunction against four certified registered nurse anesthetists, barring them from practicing within a 20-mile radius of their former workplaces for three years Testimony showed the CRNAs’ new employer, Longview, Texas-based EmergencHealth, had agreed to cover legal costs and damages tied to the non-compete violations. The court ruled that such arrangements do not invalidate enforceable restrictions. The case will proceed to trial June 8, 2026.
The case reflects an ongoing conflict across healthcare as noncompete agreements become increasingly criticized as a barrier to physicians and other clinicians already facing significant labor shortages.
“Noncompetes and the way that they’re used serve as a blanket restrictive covenant for physicians when they sign a contract is really problematic,” Marcelo Hochman, MD, an independent physician and former president of the Independent Doctors of South Carolina, told Becker’s. “It abridges the patient’s rights to follow their doctor if their doctor is going to leave the hospital system and now they have to move X miles away. That patient may not have that option, [especially] senior patients, or maybe even just geographically … 30 minutes, 45 minutes away may just not be feasible, or you may just not want to do that.”
2. Inconsistent policy enforcement: A provision buried in the Affordable Care Act already prohibits reimbursing certified registered nurse anesthetists at a lower rate than physicians for the same work. It just has never been enforced, Jeff Tieder, MSN, CRNA, a clinical assistant professor at the University of Tennessee at Chattanooga told Becker’s.
“The frustrating thing is there’s actually a non-discrimination provision in the ACA that technically prohibits reimbursement discrimination based on provider degree. But the Office of the Inspector General has never issued the final ruling to enforce it,” he said. “So this law exists, and it just doesn’t get applied. If someone on either side of the aisle would say, ‘This was passed by Congress, let’s enforce it,’ it would stop being political. The big physician groups would collect more money; CRNAs would be reimbursed at the same rate for the same work. It would help everyone, except the insurance companies, and that’s probably why it hasn’t moved.”
3. More states update CRNA policies: Ohio has become the 45th state to update its laws governing the relationship between CRNAs and physicians, replacing a physician supervision requirement with a collaborative framework.
In April 2025, both West Virginia and Kansas updated their CRNA laws to expand CRNAs practice capabilities.
4. Caps on student loan limits: The U.S. Department of Education’s proposed rule going into effect in July would cap narrow which programs are considered “professional degrees,” which will be allowed a higher student loan borrowing limit of $2000,000. Nursing would not be included in this narrowed definition, thus given an annual borrowing limit of $20,500, and a total borrowing limit of $100,000.
Houston Public Media highlighted this development in an April 6 report, noting its potential impact on Texas’ struggling CRNA workforce. Teneisha Howard, MSN, RN, president of the Metroplex Black Nurses Association and a nursing professional development specialist, told the publication that the new rule runs counter to the “reality of our health care needs,” given the shortage of nurses in Texas. Serena Bumpus, DNP, RN, CEO of the Texas Nurses Association, told Houston Public Media that prior regulation also did not include nursing on the list of professional degrees, but also treated the list as nonexhausted.
“[The DOE] just didn’t have any controls essentially around who was getting higher limits,” she said. However, the One Big Beautiful Bill Act passed last year required DOE to identify which programs will be eligible for higher federal student loan limits.
According to the state health department, Texas has one of the worst nursing shortages in the U.S. The Texas Center for Nursing Workforce Studies projects there will be a deficit of 57,000 full-time RNs by 2032, according to the report, while Texas continues to grow in population at one of the fastest rates in the nation.
5. Coverage denials other payer shifts: Several recently updated policies by commercial payers and CMS also pose a threat to the anesthesia workforce.
According to an April 1 policy update, Anthem will no longer reimburse facilities separately for moderate sedation services beginning July 1, instead bundling reimbursement into the overall procedure or facility fee.
Physicians are also pushing back against a proposed Medicare policy that would deny coverage for peripheral nerve blocks, warning that the move could harm patients, drive up costs and accelerate the erosion of independent practice.
The procedures — minimally invasive, relatively inexpensive and widely used to treat chronic conditions including headaches, knee pain and complex regional pain syndrome — also serve a diagnostic function, helping physicians pinpoint the source of a patient’s pain before recommending more aggressive treatment.