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The AI Now Institute’s April 21, 2026 report, Uber for Nursing Part II, says gig staffing platforms including Clipboard Health, ShiftKey, CareRev and IntelyCare are lobbying state governments to exempt their businesses from rules governing traditional healthcare staffing agencies. Since 2022, lawmakers in at least 17 states have introduced related bills, the institute says. New York instead classified gig nursing platforms as healthcare staffing agencies in 2025; the report says Clipboard Health, Nursa and KARE then stopped operating in the state. The report says these apps use algorithmic pricing, nurse ratings and shift-bidding systems to fill hospital and long-term-care shifts. CareRev’s Smart Rates system recommends hourly rates using market demand and past performance, according to the institute, while some Quick Bid systems award shifts to the lowest bidder. A companion Roosevelt Institute brief found that some platforms use data-broker information on nurses’ debt levels to offer lower pay to workers with higher debt. The AI Now Institute says contractor classification can deny nurses benefits and workplace protections, while cancellations, ratings and a lack of paid orientation can affect work opportunities and safety. The ten largest gig-nursing platforms have raised about $1.4 billion, the report says, including ShiftKey’s reported $2 billion valuation and Clipboard Health’s $1.3 billion valuation.