What We Are Working Toward
The diagnosis is structural. The treatment is structural. And if the treatment works, the prognosis is genuinely good, not just for the profession, but for the patients who need it most.
What We Can Realistically Expect
If Oregon and Washington establish state-regulated licensure pathways, we expect:
- Training programs to emerge that are modular, regionally accredited, and financially sustainable: producing competent practitioners without the debt loads that currently drive people out of the profession before they can fully enter it.
- Employer and insurer relationships to be built into curriculum design from the start, breaking the structural isolation that has kept acupuncture on the margins of the healthcare system it should be part of.
- Practitioner supply to stabilize and grow, particularly in the underserved rural and Medicaid-dependent communities where the workforce shortage is most acute.
- Acupuncture to become more meaningfully integrated into Oregon and Washington’s responses to the opioid crisis, behavioral health crisis, and chronic pain epidemic, where the evidence for its effectiveness is strong and the need for non-pharmaceutical options is urgent.
On the Pushback We Expect
We anticipate opposition from those who conflate credential structure with scope of practice, or who believe that the existing pathway’s length and cost are themselves markers of quality or legitimacy. We welcome that debate. The workforce data, the debt data, and the school closure data are all public. We are not arguing that training acupuncturists should be easy. We are arguing that it should not require six-figure debt to access a credential that does not command six-figure earnings.
Open Questions We Are Actively Pursuing
Not everything is resolved, and we are committed to transparency about what we are still working through.
Portability is a real and complex issue. A practitioner licensed through a state pathway in Oregon needs to be able to practice in Washington, and eventually beyond. We are building portability coordination into our advocacy from the start, but the details of reciprocity agreements between states will require careful policy work. We expect this to be a temporary bridge for the workforce until a national solution is enacted that allows the structural changes we are pushing for.
Medicare recognition for acupuncturists does not yet exist. Acupuncturists are not currently recognized Medicare providers, regardless of training pathway. Federal legislation to change this, the Acupuncture for our Seniors Act, is actively being pursued. Its qualifying language defines a “qualified acupuncturist” as someone licensed by a state, which aligns with how every other provider type is treated under Medicare and is fully compatible with state-regulated licensure pathways. The ASA’s own 2019 comment to CMS proposed exactly this standard. We are cautiously optimistic that the federal Medicare trajectory and the state pathway work are pointing in the same direction, and we will advocate for state pathways to be designed accordingly.
The Longer Horizon
This is a bridge. We are building it because the profession cannot wait for a perfect national solution. The current accreditation monopoly is producing a workforce crisis in real time: schools are closing, practitioners are aging out, and communities are being left without providers.
We believe it is likely that a new national accreditor will eventually emerge, and that when it does, the pathways and standards developed in Oregon and Washington can serve as a model. Until then, we are working to build what the moment requires: rigorous, state-regulated, debt-sustainable routes into a profession that the Pacific Northwest, and the country, urgently needs.