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Healthcare Special on Medicare Advantage and Vertical Consolidation, Pharmacy Benefit Mafia plus Billionaires vs Lina Khan; FTC W ins N oncompete C hallenge
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Access to affordable and quality healthcare is one of the most important issues facing Americans. Almost everyone, from medical industry professionals to their patients, agrees the system is fundamentally broken. The sector is fraught with excessive consolidation, vertical integration, and shady middlemen — problems that combine to cause prices to go up even as the quality of care falls. Workers and patients are unhappy, while polls routinely show healthcare is a top priority of voters across the country. The concern spans traditional left-right divides.
At Economic Liberties, healthcare is a key area of focus as we work to address the problems of this opaque and complex, life or death industry. We are releasing trailblazing research products, stepping forward to define the media narrative in crucial moments, and arming policymakers with the resources they need to push anti-monopoly policies in the health care sector. Here’s our progress so far:
THE LATEST
A Glass-Steagall for Healthcare
The April publication of our widely shared whitepaper, “Medicare [[link removed]] Advantage and Vertical Consolidation in Health Care [[link removed]] ” made waves with lawmakers on Capitol Hill. It was featured in prominent national outlets like the Washington Post [[link removed]] , local [[link removed]] and specialty [[link removed]] outlets, and adapted excerpts were published in the New England Journal of Medicine [[link removed]] and The Hill [[link removed]] . This paper, which is the is the capstone of our healthcare work to date, dissects the policy failures that allowed vertically integrated giants like UnitedHealth Group to swallow up US healthcare—with devastating consequences for patients, doctors, and taxpayers—and lays out a suite of policy tools to rectify them, including a “Glass Steagall for Healthcare” barring insurers from owning providers. Senior Fellow for Healthcare and author Hayden Rooke-Ley will discuss the paper with Senior Policy Analyst Emma Freer at our Beyond Antitrust policy talk TODAY, July 31 at 11:00am EST ( register [[link removed]] here [[link removed]] ).
Looking further ahead, stay tuned for a new brief pulling back the curtain on Pharmacy Benefit Managers’ (PBMs) mafia-esque power over pharmaceutical markets!
Enforcers Crack Down on Medicine Price Gougers, Lowering Costs for Patients
The FTC is reportedly preparing to sue dialysis providers DaVita and Fresenius — who effectively maintain a dialysis duopoly — over their use of clinician noncompetes to control this lucrative and life-saving market. Research Director Matt Stoller shed light on the practice months before news of the FTC’s investigation broke in his newsletter [[link removed]] .
Government regulators are also paying closer attention to PBMs. Earlier this month, the FTC released the initial results of a study [[link removed]] showing these middlemen inflated consumer prices for critical drugs, including cancer drugs, by steering patients to more expensive options that generated fatter rebates from drugmakers. We’ve been on the case since 2022 [[link removed]] , and called attention to this dynamic in recent briefs on PBMs [[link removed]] and group purchasing organizations [[link removed]] —another extractive pharma middleman. Now, earlier this month, r [[link removed]] eports [[link removed]] emerged that the FTC is close to filing suit against large PBMs. That’s something patients and pharmacists alike can celebrate. The PBMissue has strong bipartisan resonance, as seen during a hearing [[link removed]] earlier this month with the heads of Express Scripts, CVS Caremark, and OptumRx. Lawmakers at the federal and state level ( PA [[link removed]] , IL [[link removed]] ) also have these monopolists in their crosshairs.
In addition to PBMs, the FTC’s campaign to lower drug costs by targeting pharma companies’ use of bogus patents to extend monopoly protection on established medicines like asthma inhalers continues to make progress. This strategy, which we called for in both May 2023 whitepaper [[link removed]] and an op-ed in The Hill [[link removed]] last September, has already forced Big Pharma companies like Boehringer Ingelheim, AstraZeneca and GlaxoSmithKline [[link removed]] to cap monthly inhaler costs at $35. Previously, they were charging anywhere between $200 to $600, offering a great example of how antitrust enforcement can directly pay off for patients. Don’t miss this patient’s recent testimony [[link removed]] on how this policy is changing lives.
Pennsylvania and Oregon Take On Healthcare Monopolies
Earlier this month, the Pennsylvania House passed two major bills tackling consolidation in healthcare. One creates a health care merger notification standard, while the other empowers the state attorney general to examine and block health care mergers. We worked closely with policymakers to make these bills a reality, and their passage follows work we’ve done in Pennsylvania with partners like Summer Lee [[link removed]] to highlight the labor and patient abuses of notorious hospital monopolist University of Pittsburgh Medical Center. Something else to note: the DOJ is reportedly investigating [[link removed]] UPMC, according to the Capitol Forum , for using its market power to reduce wages for its workers.
We also mobilized a coalition of advocacy groups to push the Oregon State House to pass a bill that would would ban noncompetes for health care providers and close a series of loopholes in the state’s corporate practice of medicine (CPOM) laws. These loopholes “allowed corporate entities, including many private equity firms, to hoover up medical practices and cause a range of harms, including higher prices, worse care, and deteriorating conditions for workers,” as Director of State and Local Policy Pat Garofalo wrote in his Boondoggle [[link removed]] newsletter. Despite an immense lobbying campaign from Big Medicine, the bill ended up passing the Oregon House — showing promise for future CPOM legislation. You can read our full testimony in support of the bill here [[link removed]] .
The Fight Against Corporate Manipulation of Housing Markets
Across the city, state, and federal levels, Economic Liberties is turbocharging anti-monopoly housing policies that address core issues [[link removed]] in the housing affordability crisis: consolidation and price fixing. Following our brief [[link removed]] with Local Progress earlier this year on how states and cities can take on RealPage’s algorithmic price-fixing software, we’ve been hard at work moving these policies through government. Last night, San Francisco became the first city to ban [[link removed]] algorithmic price-fixing of rents on the municipal level, a strategy Senior Legal Counsel Lee Hepner discussed in the San Francisco Chronicle [[link removed]] and KQED [[link removed]] . In Congress, Sen. Amy Klobuchar introduced a bill [[link removed]] — which we have endorsed and supported — empowering antitrust enforcers to scrutinize and block large-scale acquisitions of residential properties by corporate investors. We’ve also seen an uptick in recent enforcement efforts on price fixing, including multi-district class action litigation [[link removed]] in the Middle District of Tennessee, a brewing price fixing probe [[link removed]] from the Antitrust Division, and federal and state antitrust lawsuits filed by DC Attorney General Schwalb [[link removed]] and Arizona Attorney General Mayes [[link removed]] .
BONUS: Billionaires vs Anti-Monopolists
ICYMI, last week, shortly after VP Harris became the presumptive Democratic nominee, billionaires like Reid Hoffman [[link removed]] , Barry Diller [[link removed]] , and Barry Sternlicht [[link removed]] took to the airwaves calling for a slowdown in antitrust enforcement and for Chair Lina Khan to be ousted from a potential Harris administration. As we pointed out [[link removed]] , and as seen by the wave of support from elected leaders [[link removed]] to unions [[link removed]] to independent pharmacists [[link removed]] to entrepreneurs [[link removed]] , the anti-monopoly agenda led by Chair Khan and other enforcers is popular because it stands up to corporate bullies on behalf of working people. We are here to defend this pro-worker, pro-small business, pro-consumer agenda — so watch this space to learn how you can join in.



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