House subcommittee hears competing views on HR 8347 to protect locum tenens status

The House Education and the Workforce subcommittee on Workforce Protections held a hearing on HR 8347, the Rural Healthcare Act, which would clarify that qualified locum tenens clinicians are independent contractors under federal labor law. Supporters said the change would preserve patient access in rural and underserved areas; opponents said it would remove worker protections and could harm care quality.

Proponents framed locum tenens as a practical, immediate response to shortages. Jonathan Wilson, a senior fellow at the Nuscan Center and visiting fellow at the Institute for the American Worker, told the panel locum tenens clinicians ‘‘are critical to patient access’’ and said many communities face long waits and long travel for specialty care. Wilson cited recruiting timelines—about 189 days for a primary care physician and 226 days for a specialist—and a projected physician shortfall in coming years, arguing a safe harbor that protects independent-contractor status under the Fair Labor Standards Act, the National Labor Relations Act and the Internal Revenue Code would reduce placement risk for facilities and clinicians.

Autumn Beay, senior corporate counsel at CHG Healthcare, described the placement model from the industry perspective and provided placement numbers: CHG placed 11,770 locum tenens providers in 2025 and estimates those clinicians supported roughly 24 million patient visits that year. Beay said uncertainty created by state laws and regulatory rules has led some facilities and staffing firms to avoid placements in certain states, and urged the subcommittee to advance HR 8347 to ‘‘protect the pipeline’’ that serves rural and tribal hospitals.

Several witnesses emphasized that locum tenens are not the same as gig nursing platforms. Dr. Katie Wells, a senior fellow at the AI Now Institute, warned that platform-driven gig nursing models use opaque algorithms, sometimes auctioning shifts and producing unexplained pay differentials between nurses at the same facility. ‘‘To win a shift, a nurse must offer to work for lower rates than her peers. It is a race to the bottom,’’ she said, and added that such systems can undermine orientation, continuity of care and worker recourse. Wells pointed to state-level bills seeking to exempt platform providers from minimum-wage or unemployment-insurance requirements, and said algorithmic management raises transparency and safety concerns.

Labor-economics testimony presented evidence that locum tenens work largely coexists with traditional W-2 employment rather than replacing it. Dr. Leah Palashilli, a labor economist at the Marquada Center at George Mason University, said roughly 90% of covered clinicians remain traditionally employed and that self-employment among advanced clinicians is concentrated among older workers seeking flexibility. She warned that broad classification laws, such as California’s AB5, led to declines in self-employment in affected occupations and could unintentionally reduce the clinician supply in places that depend on flexible staffing.

Members pressed witnesses on trade-offs between access and worker protections. Chairman Wahlberg asked whether legal uncertainty discourages facilities from using locum tenens; witnesses agreed that risk-averse counsel sometimes advise against placements. The ranking member argued weakening worker protections would not solve rural shortages and urged targeted investments in workforce development, training and loan repayment.

No formal committee action or vote occurred during the hearing. Members said the record would remain open for 14 days for written submissions.

What’s next: The subcommittee gathered perspectives and data; lawmakers will weigh whether to amend HR 8347, pursue alternatives such as targeted workforce investments, or further examine platform practices and state-law interactions before any markup or floor consideration.