After sunrise review, legislatures usually reject licensure, though they enact licenses more often than reviewers recommend them. This is consistent with the concern animating sunrise laws: Political processes are prone to capture by special interests, leading to unwarranted regulatory growth. To explore whether legislatures heed sunrise recommendations, we researched the legislative outcomes of each sunrise review, focusing on regulations of personal qualifications. 1

Where a state reviewed the same occupation more than once, we would, ideally, have looked at what the legislature did after each sunrise review. However, this type of historical research is extremely complex. Instead, we researched only the regulatory status of each occupation as of 2018, the year after the last reports in our dataset. 2 For instance, if a state reviewed an occupation three times and licensure was the eventual outcome, we counted licensure as the outcome of all three reviews—no matter what the legislature did between reviews. Not only did looking only at these “final” outcomes ease data collection, but it also allowed us to focus on how many occupations ultimately became subject to licensure. This is arguably the most important question given that licensure is both the most restrictive form of occupational regulation and the form most frequently proposed. Prior research also suggests multiple requests by professional associations and interim regulations are often merely a strategy for achieving the desired ultimate outcome of licensure, 3 making a “final outcomes” approach particularly relevant.

This approach is not, however, without some limitations. First, looking only at final outcomes likely underestimates sunrise reviews’ effects in the short term. Often when states enacted licenses, they did not do so until a decade after sunrise review, suggesting reviews’ influence on legislatures is greater in the short term but diminishes over time. Second, a focus on final outcomes does not factor in changes in occupations’ regulatory status over time. It was not unusual for a legislature to enact one form of regulation following a first review of an occupation and then licensure following a subsequent review, but we did not attempt to track such interim outcomes.

Figure 7 provides legislative outcomes for all reviews across all outcome categories; it also compares sunrise recommendations with legislative outcomes across all reviews for select outcome categories. It shows legislatures declined to enact new occupational regulations nearly half the time (49%)—almost as often as recommended (54%), suggesting legislatures may heed broad warnings against regulation. However, they also enacted a new or distinct license following 41% of reviews—about twice as often as recommended. Other types of legislative outcomes trailed both no new regulation and licensure. 4

Figure 7: Legislatures Enact Licensure More Often Than Reviewers Recommend It—But Legislatures May Heed Broad Warnings Against Regulation

Figure 7A: Legislative Outcomes for Sunrise Reviews

Figure 7B: Sunrise Recommendations vs. Actual Outcomes for Select Categories

Note: This is an aggregate analysis; it does not compare specific recommendations to their outcomes. Recommendations of no new regulation mean just that; outcomes of no new regulation mean no new regulation of personal qualifications. The legislature may have enacted other regulations, such as business regulations.

Where legislatures enacted licenses, they often did not do so immediately following sunrise reviews, suggesting that reviews’ influence is strongest in the short run—and that their influence fades over time. Often, it was several years after an initial review before legislatures enacted licenses. In a few cases, it was decades: Virginia licensed massage therapists 21 years after its first review. 5 Likewise, Hawaii licensed respiratory therapists 24 years after its first review and 15 years after its second. 6

Just as states vary in how often their sunrise reviews recommend licensure, they vary in how often their legislatures enact licenses. Table 9 and Figure 8 compare overall rates of new and distinct license recommendations and outcomes for all reviews, by state. It shows Utah never enacted licenses following sunrise review, though it conducted only a few reviews. Maine and Georgia enacted licenses following just 15% and 26%. At 39%, Colorado’s licensure enactment rate is quite a bit higher, but this is a product of the state’s unusually high number of repeated reviews. Accounting for those repeats brings Colorado’s licensure enactment rate down to 26%. On the other end of the spectrum, Arizona and Vermont enacted licenses most frequently, following 64% and 63% of reviews.

Licensure enactments exactly match licensure recommendations in two states, Kansas and Utah, but both have few reviews. Hawaii, Vermont and Washington see the largest gulfs between licensure recommendations and licensure enactments (14% vs. 48%; 25% vs. 63%; 14% vs. 49%). Only one state, Arizona, recommended licenses more often than the legislature enacted them (72% vs. 64%). That this occurred in the state with the highest licensure recommendation rate by far highlights a danger of a poor sunrise process— instead of slowing the growth of licensing, it could create a path for more.

Multiple factors could contribute to variation in enactment rates. One might be whether legislatures find reviews persuasive. Perhaps legislatures in Hawaii and Vermont are less persuaded by their states’ reviews recommending against licensing, despite their rigor. Legislators might lack confidence in the sunrise process, or legislator turnover during the sunrise review might result in more regulation-friendly legislators receiving the report than those who requested it. Or perhaps industry lobbyists are more influential in some states.

Table 9: New and Distinct License Recommendations vs. Legislative Outcomes by State

South Carolina*1817%33%
West Virginia2330%48%

Note: * = does not regularly produce reports. Colorado had an unusually high number of repeat reviews. Excluding those, its licensure enactment rate drops to 26%.

Figure 8: New and Distinct License Recommendations vs. Legislative Outcomes by State

All told, legislatures enacted 158 new licenses following sunrise review, including 84 that sunrise reviews did not recommend (see Table 10). 7 Those 84 licenses affect vast numbers of people. Though information about active licenses (as of 2021) was publicly available online for 42 of them, we identified at least 107,000 individuals who had to obtain licenses because of legislatures’ failure to follow sunrise recommendations. This is likely a massive undercount. Not only does it represent just half the 84 licenses enacted without sunrise recommendations in support, but it also excludes expired or revoked licenses. Our analysis also excludes distinct licenses, as well as analogous licenses from non-sunrise states.

Table 10: 84 New Licenses Enacted Without Sunrise Recommendations in Support

Addiction CounselorsVermont
Asbestos Air SamplersColorado
Athletic TrainersFlorida
Behavior AnalystsVermont
Certified Medication AidesArizona
Conveyance ContractorsColorado
Conveyance InspectorsColorado
Conveyance MechanicsColorado
Crane Operator ApprenticesHawaii
Crane OperatorsHawaii
Dental Hygienist, Mid LevelVermont
Dialysis TechniciansColorado*
ElectriciansSouth Carolina
Fire Damper TechniciansWest Virginia
Fire Sprinkler FittersWest Virginia
Genetic CounselorsHawaii
Hearing Aid DispensersColorado
Home InspectorsFlorida
HVAC TechniciansSouth Carolina
West Virginia
Judges, Mixed Martial ArtsHawaii
Lactation ConsultantsGeorgia
Landscape ArchitectsColorado*
Managers, Mixed Martial ArtsHawaii
Marriage and Family TherapistsColorado
Massage TherapistsColorado*
Matchmakers, Mixed Martial ArtsHawaii
Medical AssistantsWashington
Medical Nutrition TherapistsNebraska
Mental Health PractitionersWashington
Mortgage BrokersColorado*
Motor Vehicle SalespeopleWest Virginia
Occupational TherapistsColorado*
Occupational Therapy AssistantsColorado*
Pharmacy TechniciansVirginia
Physical Therapist AssistantsWashington*
PlumbersSouth Carolina
West Virginia
Professional CounselorsColorado
Property ManagersVirginia
Radiographers, Limited ScopeNebraska
Radiologic TechniciansNebraska
Real Estate AppraisersWashington
Respiratory TherapistsHawaii*
Seconds, Mixed Martial ArtsHawaii
Social Workers, BachelorHawaii*
Social Workers, MastersHawaii*
Social Workers, SeniorHawaii*
Speech Language PathologistsColorado
Speech Language Pathology AssistantsVirginia
Timekeepers, Mixed Martial ArtsHawaii
Utility ContractorsGeorgia
Vocational Rehabilitation CounselorsVirginia

Note: * = multiple reviews recommending against licensure or making no recommendation. † = 42 occupations for which active licensee counts were publicly available. Actual license names may vary across states.

In these 84 instances, politics as usual may have won out despite the independent analysis provided by sunrise review. On the other hand, legislatures often do heed sunrise recommendations. In our data, they rejected 189 new licenses that reviewers recommended against or failed to recommend. While some licensing proposals may have failed for other reasons, the many matches between sunrise recommendations and legislative outcomes suggest sunrise reviews are often successful in persuading legislatures not to license occupations.

Taken together, these findings suggest sunrise processes do not completely overcome the political problem animating sunrise laws. At best, they serve as a counterbalance. Our findings also underscore that sunrise does not trump or outsource legislative decision-making: Legislators retain their prerogative to set economic and regulatory policy. But when done well, sunrise reviews can give them valuable information with which to craft sound policy.