Tech platforms operating gig-work nursing services are waging an aggressive campaign to deregulate their industry, pushing lawmakers across the country to exempt them from healthcare staffing rules and worker protection laws, according to a new report from the AI Now Institute released Tuesday.
Three nurse gig platforms have already reached billion-dollar valuations by tapping private equity investment and securing contracts to staff public facilities, including Immigration and Customs Enforcement detention centers. The business model mirrors ride-sharing in its use of artificial intelligence to manage workers: algorithms set pay rates, monitor performance, and determine whether nurses get access to future shifts.
The system operates as a race to the bottom. Nurses bid against each other for shifts, with the lowest wage offer winning the job. Clipboard Health, one of the major platforms, openly advertises this auction format to its workers. The same platforms deploy AI-driven disciplinary systems that penalize nurses for canceling shifts or arriving late, deducting points that can affect their access to work.
"AI is incorporated into all these human management software systems, and for nurses, that means dropping them into all kinds of places, without orientation, without workers comp, without any way to protect themselves if they're sick and they need to cancel," said Dr Katie J Wells, a senior fellow at AI Now and co-author of the report.
The lobbying blitz has gained significant ground. Since 2022, lawmakers in at least 17 states have introduced bills designed to exempt gig nursing platforms from the regulations that apply to traditional healthcare staffing agencies. Eight states have advanced such exemption bills, including Colorado, Illinois, Iowa, Louisiana, Minnesota, Missouri, Nevada, and Rhode Island. Six additional states have passed policies exempting these platforms from worker protection laws entirely.
Two states have already granted full exemptions. West Virginia removed gig nursing platforms from worker protection laws, while Louisiana exempted them from unemployment insurance requirements.
The report, titled "Uber for Nursing Part II: How Gig Nursing Companies Are Lobbying States to Deregulate Healthcare," frames these efforts as echoing the playbook perfected by ride-sharing companies, which successfully avoided being classified as transportation or taxi services subject to existing regulations.
At the federal level, gig nursing companies have lobbied for legislation expanding "independent work" and backing a bill that would allow them to secure government contracts during emergencies while shielding them from liability for patient injuries.
The push comes as healthcare remains one of the few sectors experiencing steady job growth in the United States. Wells expressed concern that the model could spread across the industry if unchecked.
"There's a huge concern that if this model continues to gain acceptance or carve outs, a lot of jobs, I think, could go this way," Wells said. "We focus so often on how AI is going to replace your jobs, and, OK, maybe. But also, first AI is going to totally degrade it and leave you without protections."
New York has moved in the opposite direction. The state passed a law in 2025 requiring gig nursing platforms to comply with standard healthcare staffing agency regulations, positioning itself as a potential counterweight to the deregulation wave.
Author James Rodriguez: "These companies are betting states won't notice they're dismantling a century of worker protections while patients get handed off to untrained contractors with no safety net."
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