Quick Hits

• Healthcare employers will have to navigate several labor and employment law issues in 2025, including a potential continued rise in union organizing, new restrictions on the use of noncompete agreements, emerging workplace safety risks, compliance concerns, additional pay transparency laws, and immigration regulatory and enforcement changes.
• The issues arise as the new presidential administration seeks to shift federal policy on several of the key issues, including labor relations and immigration.
• Healthcare employers may want to monitor these developments and consider steps to adapt to this evolving landscape and remain compliant and competitive.

Here is a close look at critical issues that will shape the current environment and are poised to significantly impact the industry’s future.

Labor Organizing Efforts

Organizing efforts among healthcare professionals, notably including physicians, have been gaining momentum in recent years, in part brought on by COVID-19 pandemic. In addition, several healthcare union contracts are set to expire in 2025, meaning many healthcare employers will be engaged in negotiations that will likely impact the industry for years to come.

The National Labor Relations Board (NLRB) has issued several union-friendly rulings over the past two years, making it more difficult for employers to challenge majority union representation status and express concerns about the impact of unionization on workplace dynamics. However, President Donald Trump, who was sworn into office on January 20, 2025, has taken actions to shift the NLRB’s political leadership and policy priorities.

Restrictions on Noncompete Agreements

The use of noncompete agreements, which restrict doctors, nurses, and other healthcare employees from working for competing healthcare facilities for certain periods of time and in specific geographic areas after leaving their current employers, has faced increased scrutiny in recent years. In April 2024, the Federal Trade Commission (FTC) sought to ban nearly all noncompete agreements in employment, though federal district courts enjoined that effort in Florida and Texas (currently being considered on appeal). However, it is not expected that the new presidential administration will seek to continue with this rule.

In the meantime, states have increasingly sought to regulate noncompete agreements and restrictive covenants in employment in recent years in ways that will impact healthcare employers. Notably, Pennsylvania Governor Josh Shapiro, in July 2024, signed a law to prohibit certain noncompete agreements with doctors. The law, which went into effect on January 1, 2025, prohibits “noncompete covenant[s]” with time periods of more than one year entered into by healthcare practitioners and employers, as well as imposes certain notification requirements on healthcare employers. Notably, Pennsylvania was previously one of a dozen states with no laws restricting noncompete agreements.

Emerging Workplace Safety Challenges

Workplace safety has always been a paramount concern in the healthcare industry, given the inherent risks associated with patient care. However, recent developments in the wake of the COVID-19 pandemic have brought new challenges and heightened awareness of the importance of comprehensive safety protocols.

The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) and a growing number of states have made protecting doctors, nurses, and other healthcare workers who have direct patient interaction from workplace violence a priority. OSHA has been preparing a proposed standard on workplace violence prevention in healthcare settings, which had been slated to be released in December 2024.

Healthcare employers may want to review their workplace safety practices and ensure they address emerging risks. Updates can include additional physical safety measures, such as improved personal protective equipment (PPE) and infection control protocols, initiatives that support the mental health and well-being of healthcare workers, new technologies for risk mitigation, and continued safety training and planning.

Pay Transparency Compliance Obligations

Pay transparency compliance is also becoming an increasingly important issue in the healthcare industry as healthcare organizations strive to attract and retain top talent. A growing list of more than a dozen states and the District of Columbia have enacted pay transparency laws, requiring employers to disclose in postings for new jobs and internal promotions details such as pay ranges, benefits, bonus structures, and other compensation information. New laws in Illinois and Minnesota already took effect on January 1, 2025, with laws in New Jersey, Vermont, and Massachusetts set to take effect later in the year.

New Immigration Regulations and Enforcement

Immigration is a critical issue for the healthcare industry, which relies heavily on international talent to fill various roles, from physicians and nurses to researchers and support staff. Potential changes to U.S. immigration laws and regulations—including changes to visa requirements, work authorization processes, and other programs—in 2025 may significantly impact the ability of healthcare employers to recruit and retain skilled professionals from abroad.

Notably, the U.S. Department of Homeland Security (DHS) revamped the process for H-1B “specialty occupation” visas with a new rule that took effect on January 17, 2025. Further, in his first days in office, President Trump signed several executive orders (EO) seeking to implement more restrictive U.S. immigration policies.