This article originally appeared in the Washington Post August 5, 2026.

Anne Davis is a psychotherapist who spent two decades counseling homeless people and patients with mental illness in Colorado. But when she moved home to Michigan — which has a severe shortage of counselors, social workers and therapists — it took more than a year for the state to allow her to get back to work.

The state desperately needs therapists like Davis. According to the National Alliance on Mental Illness, more than 3 million Michiganders live in a community that does not have enough mental health professionals. The state is facing a shortage of therapists and psychiatrists. But Michigan’s licensing laws have made it difficult to fill these gaps.

The Wolverine State’s struggle to attract mental health professionals is a symptom of the broader problems caused by America’s patchwork of occupational licensing laws. States often do not easily recognize licenses from other states, blocking professionals from working and people from obtaining services. Across dozens of professions, recognition of out-of-state licenses by the state of Michigan is arbitrary and convoluted. These barriers make it harder for Michiganders to find a therapist or schedule a root canal. They have fewer options and face higher prices due to less competition.

It makes little sense that professionals like massage therapists, dentists and cosmetologists must get new training or take new tests just because they move states. But licensing laws often require that they do, even if they have been working safely and successfully in their career for decades.

Every state has at least limited reciprocity for some out-of-state licenses — but many professions are not covered. Other occupations participate in compacts that apply to some states, like the Interstate Medical Licensure Compact for physicians or the Nurse Licensure Compact.

Piecemeal solutions like these can cause confusion, delays and hurried legislative fixes. Michigan is not in the nursing compact, which means nurses trained in the state have a degree less valuable than it should be. And a nurse in Indiana wanting to move to Michigan has less reason to do so. Though Michigan is in the compact for physicians, the law authorizing its membership had a sunset clause that put roughly 8,000 physicians who live or work in the state in danger of losing their licenses before lawmakers removed the clause at the last minute in March.

The winners in this arrangement are professionals who already work in the covered industries. Michigan dentists can worry less about competition because licensing rules make it harder for Ohio dentists to move to the state. The same is true in other industries, which often lobby for strict licensing regimes. Though occupational licenses are supposed to protect the public, these barriers function as basic protectionism.

More than half of states have some type of universal law recognizing licenses gained in other states. The Archbridge Institute grants 10 of these states a “gold medal” for their reciprocity laws. A gold medal means anyone properly licensed or working in a profession can move to the state and begin working quickly and easily.

Indiana and Ohio, Michigan’s neighbors, are on that list. They are doing better economically, and one factor in the difference might be this: Licensed professionals in good standing are unlikely to move to a state where they must repeat training, wait months for officials to compare nearly identical credentials or stop serving a longtime patient.

The good news is that Michigan lawmakers are working on a fix, and several proposals are making their way through the state legislature. One bill would broaden reciprocity. A more comprehensive package would essentially enact universal reciprocity.

Passing either bill would be a vast improvement. Michigan should uphold a simple principle: If another state has already licensed someone, and that professional has safely practiced for years, licensing boards should recognize that achievement. There needs to be a good reason to block a licensed professional from quickly getting to work in Michigan.

But this is not just a Michigan problem. Automatic license recognition helps states compete for workers, expand access to health care and make it easier for families to relocate. Lawmakers should stop treating borders as barriers to honest work.

Permission to reprint this blog post in whole or in part is hereby granted, provided that the author (or authors) and the Mackinac Center for Public Policy are properly cited.