Gig Nursing Bills Are Spreading Across the States. Here’s What They Mean for Healthcare Staffing Platforms.

This is a guest post by Dave Barmore of Runway Strategies.

Healthcare is the newest front in the fight over independent contractor classification. As Bloomberg Law reported in August, lawmakers in more than a dozen states have now considered bills regulating “healthcare worker platforms,” the apps that hospitals and nursing homes use to post open shifts for nurses and other clinicians who want to pick up a few hours or a day of work.

The bills vary widely. Some exempt platforms from traditional staffing agency rules. Others impose new obligations, like licensing, background checks or bans on noncompetes. And a handful go further, writing independent contractor status for platform workers directly into state law.

For any company that engages licensed healthcare workers on a 1099 basis, the direction of these bills matters. Here’s where things stand, and what the emerging state frameworks have in common.

Three approaches states are taking

1. Declaring platform workers independent contractors. Some states have chosen to settle the classification question by statute. Utah’s 2025 law (SB 228) explicitly provides that nurses picking up shifts through platforms are independent contractors, not employees of either the platform or the facility. Ohio’s SB 423, which passed the state Senate unanimously in June, takes a similar approach.

2. Regulating platforms without resolving classification. Other states have focused on safety and accountability. Rhode Island enacted a law (H 7030) this year requiring platforms to be licensed and to conduct licensing and background checks on the clinicians who use them. New York took a different path in 2025, deciding through S 3355 that app-based platforms are covered by the same requirements as temporary healthcare staffing agencies, regardless of whether their nurses are employees or contractors.

3. Carving platforms out of employer obligations. Georgia’s HB 991 would have exempted healthcare technology platforms from paying into the state unemployment insurance fund for nurses who use them, if the companies met certain conditions. It cleared a House committee but never got a floor vote, and its sponsor has said he plans to reintroduce it.

Where the fights are

The pattern across states is consistent: safety requirements move easily, and classification language draws opposition. Industry representatives have said they generally support background and licensing checks, and that classification is the hardest piece to reach agreement on. In Wisconsin, opposition from the AFL-CIO and the state labor department helped defeat AB 794, an industry-backed bill that included independent contractor language. Nurses’ unions in other states have argued that expanding contracting in nursing won’t stabilize the workforce.

The federal and state backdrop just shifted

Two developments since the Bloomberg report raise the stakes.

First, the U.S. Department of Labor sent its final independent contractor rule to the White House for review on September 28, with publication expected in October. The rule would revive a test centered on two “core” factors, a worker’s control over the work and their opportunity for profit or loss, replacing the multi-factor 2024 standard. That would give companies a clearer federal framework, but it won’t override stricter state tests.

Second, New Jersey’s new ABC test regulations took effect on October 1. Under that test, a worker is presumed to be an employee unless the hiring business satisfies all three prongs, including showing the work falls outside its usual course of business. We covered the rule’s insurance provision in a separate post, Our reading of the insurance provision in New Jersey’s October 1 independent contractor rule.

The common thread: insurance and accountability

One feature shows up again and again in the healthcare platform bills that have advanced: coverage requirements. Proposals in states like Massachusetts and Pennsylvania have paired contractor status with platform-side obligations, such as general and professional liability coverage and verification that workers have occupational accident or workers’ compensation coverage. Massachusetts H 5506, which stalled when the state’s formal session ended in July, followed this model, as does Pennsylvania HB 1166, which remains pending.

That’s not a coincidence. Legislators weighing contractor status for licensed clinicians want assurance that someone is covered if a patient is harmed or a nurse is injured on a shift. Bills that answer that question tend to get further than bills that don’t.

What healthcare staffing platforms should do now

• Track the states where you operate. With more than a dozen states considering these bills, requirements will keep diverging. A platform that complies in Utah may face different licensing, registration or staffing agency rules in Rhode Island, New York or Pennsylvania.

• Expect safety requirements everywhere. Background checks, license verification and registration are becoming the baseline, even in states that never resolve classification.

• Document how your model works. Whether a state applies the federal two-factor test, an ABC test or its own statute, the facts that matter are the same: who controls scheduling and methods, whether workers can work elsewhere, and whether they bear real business risk.

• Close coverage gaps. Many 1099 clinicians don’t carry their own workers’ compensation or adequate professional liability coverage. Making sure contractors are properly insured protects the worker, the facility and the platform, and it’s increasingly what legislators expect.

The healthcare worker platform debate is following the path ride-hail regulation took a decade ago, with states writing new categories into law one at a time. Companies that build compliance and coverage into their model now will be better positioned as those rules take shape.