Hazard Pay for Nurses: Laws, Union Contracts, and Taxes

There is no federal law that guarantees hazard pay for nurses. The Fair Labor Standards Act does not address it, and no OSHA regulation requires healthcare employers to provide it.¹ Whether you receive extra pay for working through a pandemic, a disaster, or another dangerous period comes down to three things: your employer’s policy, your union contract if you have one, and any state or local program you happen to qualify for.

What Hazard Pay Actually Is

The U.S. Department of Labor defines hazard pay as “additional pay for performing hazardous duty or work involving physical hardship,” where physical hardship means work causing extreme discomfort or distress that protective equipment cannot adequately alleviate.¹ For nurses, that typically covers prolonged exposure to infectious disease, extended shifts in full PPE, and caring for critically ill patients under crisis conditions.

It is not a raise. Hazard pay is designed as a temporary premium tied to the period when conditions are genuinely dangerous, and a 2021 analysis in the Journal of Medical Ethics argued it should be structured as a per diem payment active only while the hazard persists.²

There is no standard rate. Actual and proposed amounts have ranged from a few dollars per hour in state grant programs to $13 per hour in major federal proposals. Federal employees typically receive hazard pay set at 25 percent of the regular rate, but that benchmark has no binding effect on private hospitals or health systems.³

Federal Law and Pending Legislation

Congress has never enacted a law requiring hazard pay for nurses or other private-sector healthcare workers. Every major proposal has stalled.

The 2020 HEROES Act, passed by the House, included a $200 billion “Heroes Fund” that would have paid essential workers, nurses among them, an extra $13 per hour up to $10,000 per person, retroactive to January 2020. Senator Mitt Romney’s narrower “Patriot Pay” proposal would have provided up to $12 per hour for a three-month window. Neither made it into any enacted COVID relief law. The Senate’s $1 trillion HEALS Act excluded hazard pay entirely, and by September 2020 House Democrats had dropped the Heroes Fund from an updated version of the HEROES Act.⁴

Representative Matt Cartwright’s 2021 Coronavirus Frontline Workers Fair Pay Act, which would have provided healthcare workers up to $35,000, never advanced past committee.⁵

The current bill in Congress is the Hazard Pay for Health Care Heroes Act, reintroduced on April 23, 2026, by Representatives Summer Lee and Ro Khanna and Senator Edward Markey.⁶ The House version, H.R. 8484, would amend the Public Health Service Act to create emergency grants for public and private nonprofit healthcare facilities and home health agencies. Grant funds would pay hazard pay of up to $13 per hour on top of regular wages, capped at $25,000 per worker per year, during any federally, state, or locally declared emergency. Eligible workers include nurses, home care workers, medical technologists, orderlies, public health workers, and environmental and custodial staff whose healthcare work cannot be performed remotely.⁷

The Senate companion, S. 4357, was introduced by Senator Markey on April 21, 2026, with Senator Elizabeth Warren as sole co-sponsor.⁸ As of mid-2026, neither version has advanced beyond committee referral. Until one of them passes, there is no federal entitlement to claim.

State Programs Nurses Have Actually Been Paid Under

A handful of states have run their own hazard pay programs, most funded through federal pandemic relief dollars. If you worked in one of these states during the qualifying window, you may already have received a payment or may still be eligible under an active program.

Pennsylvania. The COVID-19 PA Hazard Pay Grant program paid a $3-per-hour premium to employees earning less than $20 per hour, up to $1,200 per full-time-equivalent worker, over a 10-week window from August to October 2020. Healthcare and social assistance was one of the eligible sectors.⁹

Minnesota. Governor Tim Walz signed the Frontline Worker Pay program into law in April 2022, dedicating $500 million split equally among approved applicants. Healthcare and long-term care workers at hospitals, nursing homes, clinics, and home health agencies were explicitly eligible. Applicants had to have worked at least 120 hours in a frontline sector between March 2020 and June 2021 without the ability to telework. Over one million workers were approved, and each received $487.45, well below the statutory maximum of $1,500, because the fixed pool was split among all qualified applicants.¹⁰ The payments were exempt from Minnesota state income tax but counted as federal taxable income.¹¹

Michigan. Under Public Act 22 of 2025, Michigan extended a wage pass-through program for staff at Medicaid- and Medicare-certified nursing facilities through September 2026. Direct care workers, including registered nurses and licensed practical nurses, receive an additional $3.40 per hour for hours worked, with overtime reimbursed at $5.10 per hour.¹²

These programs reached only a fraction of the roughly 50 million frontline essential workers nationwide.⁴ Local hazard pay mandates passed in cities such as Long Beach, Seattle, Santa Monica, and Los Angeles County during COVID applied to large grocery and pharmacy retailers and did not cover hospitals or nursing facilities.¹³

Union Contracts

For unionized nurses, hazard pay is a bargaining subject. Nursing unions used the pandemic as leverage in contract negotiations. The Service Employees International Union staged a weeklong strike at Riverside Community Hospital in California over safety and compensation, and National Nurses United pushed for first contracts at newly organized facilities including Mission Hospital in Asheville, North Carolina, where roughly 2,000 nurses began bargaining after a successful unionization vote. Unions also timed the expiration of contracts covering tens of thousands of nurses at HCA Healthcare, Sutter Health, and Dignity Health to overlap during the pandemic to maximize bargaining power on staffing ratios, safety, and pay.¹⁴

If your workplace is unionized, your entitlement to hazard pay during an emergency will turn on the specific language of your collective bargaining agreement. Several labor organizations, including SEIU Healthcare Pennsylvania, the American Federation of Teachers, and the Massachusetts Nurses Association, have endorsed the pending federal bill.¹⁵

What Employers Did on Their Own

Employer-provided hazard pay has been the exception, not the rule, and where it appeared it usually did not last. In the early weeks of COVID, several large employers introduced temporary pay bumps branded as “hero pay.” Kroger offered a $2-per-hour bonus starting in late March 2020 but rescinded it in mid-May.¹³ Starbucks planned to end a $3-per-hour raise at the end of May 2020.¹⁶ Costco committed to sustain its $2-per-hour hazard pay through March 2021. Most programs ended by summer 2020.

Hospitals took a different position. In a March 2020 letter to House Speaker Nancy Pelosi, the American Hospital Association asked Congress to create $5,000 tax credits for frontline caregivers, framing extra compensation as something the federal government should fund rather than something hospitals should be mandated to provide. At the facility level, administrators resisting union hazard pay demands often argued that no comparable local hospital was offering it either.¹⁷

How Hazard Pay Is Taxed

When you do receive hazard pay, it is generally treated as taxable income at the federal and state level. The IRS does not classify hazard pay as a distinct category with its own exemption, and the pending Hazard Pay for Health Care Heroes Act does not include a provision exempting the payments from federal taxation.⁷ It increases your gross income and is subject to standard federal and state withholding, Social Security, and Medicare taxes.

State-level exemptions are rare. Minnesota’s Frontline Worker Pay was one, exempting the payments from state income tax while acknowledging they remained federally taxable.¹¹

Where That Leaves You

If you are a nurse asking whether you are owed hazard pay for working through a dangerous period, start with your employee handbook and, if you have one, your collective bargaining agreement. Both are the actual sources of any enforceable right you have. Check whether your state ran a program during the period in question and whether the application window is still open, or whether an ongoing pay pass-through like Michigan’s covers your facility type. Absent an employer policy, a union contract provision, or a state program, no federal law currently obligates a private hospital or health system to pay you a hazard premium, and no proposed bill has yet changed that.

1
U.S. Department of Labor. Hazard Pay
2
National Library of Medicine. Hazard Pay and the Ethics of Compensating Key Workers During an Epidemic
3
Every CRS Report. COVID-19 Hazard Pay for Frontline Workers
4
Brookings Institution. The COVID-19 Hazard Continues, but the Hazard Pay Does Not
5
Congress.gov. H.R. 3020 – Coronavirus Frontline Workers Fair Pay Act
6
U.S. House of Representatives — Rep. Summer Lee. Rep. Summer Lee Reintroduces Bill to Raise Hazard Pay and Strengthen Protections for Health Care Workers
7
Congress.gov. H.R. 8484 – Hazard Pay for Health Care Heroes Act
8
Congress.gov. S. 4357 – Hazard Pay for Health Care Heroes Act
9
Pennsylvania Department of Community and Economic Development. COVID-19 PA Hazard Pay Grant
10
Minnesota Frontline Worker Pay. Frontline Worker Pay
11
Littler Mendelson. New Obligations for Frontline Sector Employers Through Minnesota’s Frontline Worker Pay
12
Michigan Department of Health and Human Services. LTC Direct Care Worker Wage Pass-Through FAQs
13
Brookings Institution. Local COVID-19 Hazard Pay Mandates
14
Healthcare Dive. Healthcare Workers Unions Contracts Up Amid COVID
15
U.S. Senate — Sen. Edward Markey. Senator Markey and Rep. Lee Reintroduce Bill to Raise Hazard Pay and Strengthen Protections for Health Care Workers
16
Vox. Coronavirus Essential Workers Hazard Pay
17
ASRN. Nurses Say COVID-19 Hazard Pay Could Help Offset Unsafe Working Conditions