The Statehouse AI Tracker: AI Laws Affecting Nursing by State

Part of Nurse.org’s Nursing AI Watch series, our ongoing look at how artificial intelligence is reshaping nursing practice. Here we track the state laws starting to govern AI in healthcare — and the small handful that touch nursing directly.

While states are moving fast to integrate AI care into bedside nursing, there is still no binding federal law setting AI rules for nursing practice. As a result, the action has shifted to the states, and it’s moving at uneven speed.

Some states have enacted laws governing AI in healthcare. Some are still debating. And a handful of others have passed bills that touch nursing scope directly. What that means in practice is that the AI protections available to a nurse in California can be completely different from what exists a state line away.

To help nurses understand the evolving state governance of AI, Nurse.org created this tracker.  Here’s where the law stands, state by state, on AI in healthcare, through a nurse-scope lens.

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Based on publicly available documentation, we’ve identified 67 AI-related healthcare measures across 39 jurisdictions, meaning 38 states plus the federal government. You can cross-check the broader landscape in the NCSL AI legislation database, which tracks AI bills nationwide.

These measures are at very different stages. Some are law. Many are still working their way through the process, and a fair number have already failed. Here’s the status breakdown of what we track.

The takeaway is that activity is high, but settled law is still thin. Eighteen enacted measures across 39 jurisdictions (38 states plus the federal government) means most of the country is still debating, not deciding. 

It’s also worth saying plainly: most of these bills are not about nurses. They cover things like insurance use of AI, consumer protection, and general healthcare-AI disclosure. Only a small slice speaks to clinical practice, and an even smaller slice speaks to nursing scope.

This is the part most coverage gets wrong. Of the 18 enacted laws, only two clearly reach into nursing scope of practice. The rest are general healthcare-AI laws that may affect settings where nurses work, but they are not written specifically around nursing practice.

The two enacted laws that reach into clinical scope are California’s AB489 and Nevada’s AB406.

However, neither bill is nursing-specific: AB489 covers all licensed health professions, and AB406 focuses on mental and behavioral health. Both draw lines around when AI can stand in for a licensed clinician, which directly affects nurses. Arizona’s HB4080 is the closest nursing-specific measure, but it has only been introduced, not enacted.

Here’s a breakdown of the different bills:

The practical takeaway is simple: California and Nevada are the two enacted laws to know right now, and Arizona is the closest nursing-scope proposal to watch next.

What About AI Disclosure And “No Impersonating A Provider” Laws?

A second cluster of laws focuses on honesty: making sure patients know when they’re interacting with AI, and stopping AI tools from posing as licensed clinicians. California’s AB489 falls into this space, addressing how AI may present itself in healthcare communication.

This is the same concern driving legislation elsewhere. We’ve covered the New York bill to limit AI medical advice, which takes aim at AI systems offering medical guidance without proper oversight. The throughline across these efforts is simple: patients should know a human professional is accountable for their care, and AI shouldn’t blur that line.

For nurses, the practical stakes are real. If a patient can’t tell whether advice came from a nurse or a chatbot, accountability gets murky fast. Disclosure laws try to keep that line clear.

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Federally, there’s still no binding law aimed at nursing practice, but activity has picked up: beyond the existing HTI-1 health-IT transparency rule, the FDA issued AI guidance (June 2026), CMS stood up an AI office, and ONC opened an HTI-5 RFI (June 2026), alongside three federal AI bills in play. None are nursing-specific, but they shape the national health-IT backdrop.

We dug into this in White House AI policy leaves out nurses, which found federal AI policy has largely sidestepped the nursing workforce. With Washington quiet, statehouses have become the main venue where AI-in-healthcare rules actually get written.

For a nurse, that means your rights and protections around AI may depend heavily on which state you practice in. A tool governed one way in California may face no equivalent rule a state line away.

Expect more movement, not less. With 19 measures introduced and another 16 sitting in committee or already passed in one chamber (plus a handful still at the proposed stage), the enacted column is likely to grow over the coming cycles. Scope-of-practice bills like Arizona’s HB4080 are the ones to watch most closely, because they speak directly to nursing practice rather than to healthcare AI in general.

A longer watch list is useful here, as long as we separate nursing-scope proposals from broader healthcare-AI activity:

The other place to watch is the bargaining table. Where public regulation moves slowly, nurses’ unions have been writing their own AI rules into contracts — a private-sector parallel worth tracking alongside the statehouse fight. We laid out that emerging pattern in our look at how AI is landing in nurse union contracts.

This tracker will refresh as the picture changes. The pattern so far is clear: a lot of legislative energy, a handful of real laws, and only a couple that touch nursing scope head-on.

State legislatures are busy on AI in healthcare: 67 measures across 39 jurisdictions (38 states plus the federal government), but the settled law is still thin, and most of it isn’t nursing-specific. The two enacted laws that most directly affect nursing scope are California’s AB489 and Nevada’s AB406, though neither was written specifically for nurses. With no federal standard in place, where you practice will shape what AI rules apply to you.

Related Nursing AI Watch Analysis:

🤔 Has an AI law in your state changed how tools show up in your practice — or do you not even know what your state has on the books? Tell us in the comments below.

About the data: Nurse.org’s Nursing AI Watch tracks AI-related healthcare measures across state and federal sources, including bill-status data and public legislative summaries. We classify measures by status and whether they appear to touch nursing scope of practice, but bill language and status can change quickly.

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