Washington Post : states rein in private equity in healthcare

Washington Post analysis highlights states cracking down on private equity in healthcare

A new Washington Post Intelligence analysis underscores a growing national shift. State lawmakers are increasingly stepping in to address the risks private equity poses to hospitals, nursing homes, and physician practices. The piece, “Why states are cracking down on private equity in health care,” draws on research from the Private Equity Stakeholder Project. It cites PESP’s 2025 State Healthcare Policy Review and uses the interactive map and tracker from our website to show where, and how, states are acting.

The analysis places today’s legislative momentum in the wake of high-profile hospital bankruptcies and closures, including Steward Health Care and Prospect Medical Holdings. Those collapses intensified scrutiny of private equity’s business model in healthcare. They also helped push oversight efforts out of Washington and into state capitols, where lawmakers are advancing new rules on transparency, transaction review, and investor control.

States step in as federal action stalls

The Washington Post analysis makes clear that, with little appetite for new federal guardrails, states are emerging as the primary arena for reform. Legislators across the country are debating how to limit private equity’s ability to extract value from essential healthcare providers. Communities are often left to deal with the fallout when those efforts fail.

To explain this trend, the Post relies on PESP’s state-by-state tracking, highlighting how lawmakers are responding to rising costs, declining patient outcomes, and hospital closures linked to private equity ownership. The story points readers to PESP’s tracker as a key resource for understanding the scope of state action now underway.

What PESP’s state healthcare policy review found

Published in December, PESP’s 2025 State Healthcare Policy Review: Tracking Private Equity Oversight and Reform provides a clear snapshot of how states are confronting private equity’s growing role in healthcare. The report documents a clear escalation in legislative activity, with proposals falling into four major categories:

• Transparency and reporting requirements that force private equity firms, management companies, and healthcare providers to disclose ownership structures and financial relationships that are often hidden from regulators and the public.
• Approval and enforcement authority that gives state agencies or attorneys general the power to review, condition, or in some cases block healthcare transactions that threaten access, competition, or financial stability.
• Targeted prohibitions on practices such as hospital sale-leasebacks, which have been widely used by private equity owners to extract real estate value while saddling providers with long-term rent obligations.
• Corporate practice of medicine enforcement, aimed at preventing investors from exerting control over clinical decision-making through management contracts or other workarounds.

The review shows that these approaches are no longer theoretical. In 2025 alone, states including Massachusetts, California, Oregon, Indiana, Washington, New Mexico, and Maine enacted new laws strengthening oversight of private equity-backed healthcare. Other states are actively considering similar measures, while a number of proposals stalled amid industry opposition.

A national map of growing accountability

The Washington Post analysis prominently features PESP’s interactive map, which visualizes this rapidly evolving policy landscape. The map shows where legislation has passed, where bills remain under consideration, and where efforts failed. Together, these patterns highlight both the momentum behind reform and the resistance it continues to face.

By grounding its reporting in PESP’s research, the Post reinforces a central conclusion of the State Healthcare Policy Review: oversight of private equity in healthcare has become a mainstream policy issue. What was once treated as a niche concern is now a bipartisan response to real-world harm experienced by patients, workers, and communities.