PESP joins 16 organizations in urging the DOJ to prioritize stronger antitrust enforcement in healthcare

PESP and several leading organizations, including the American Economic Liberties Project, Americans for Financial Reform, and Community Catalyst, have joined forces to urge the U.S. Department of Justice (DOJ) to prioritize and strengthen antitrust enforcement in the healthcare sector. Their letter responds to a recent DOJ notice regarding the creation of an “Anticompetitive Regulations Task Force,” aimed at eliminating “anticompetitive” state and federal laws and regulations. 

In the letter, PESP and the other organizations called for greater oversight of consolidation and private equity in healthcare, rather than less regulation in this area. The organizations contend that increasing consolidation and private equity involvement are leading to “higher prices, lower quality of care, and reduced access to essential services.” This assertion is backed by detailed data and analysis outlined in the letter to Assistant Attorney General Slater.

Key insights from the letter:

• Consolidation Concerns: Healthcare markets have become increasingly consolidated over the last three decades. By 2022, the vast majority – 97 percent – of all metropolitan areas had hospital markets that were considered highly concentrated under federal antitrust standards. This level of consolidation, the letter argues, drives up prices and reduces access to vital services.
• Private Equity Impact: Private equity has invested over $1 trillion in the U.S. healthcare sector over the last decade. Private equity’s growing footprint is contributing to horizontal consolidation, which is often accompanied by higher prices in various subsectors. The letter also notes that private equity ownership is associated with a lower quality of care, including an increase in hospital-acquired conditions.
• Federal Recognition of Risks: The FTC, DOJ, and Department of Health and Human Services (HHS) launched a public inquiry in March 2024 into private equity, consolidation, and other corporate involvement in health system transactions. This shows that federal agencies are already aware of and investigating these issues. The letter urges the Administration to build upon this momentum.
• State Oversight Importance: State regulation is important because the threshold for federal pre-merger review is over $126 million, which allows many healthcare transactions to proceed without prior federal review. The organizations are advocating for states to have the right to implement additional oversight and work collaboratively with federal authorities.
• Root Causes of Overbilling and Consolidation: The letter urges the Administration to work with Congress to address the root causes of these issues, such as higher reimbursement for care provided in hospitals that could be safely provided in lower-cost settings.

There is a critical need for robust antitrust enforcement in healthcare. This letter serves as a call to action, urging the DOJ to prioritize patient well-being and market competition over deregulation, stating that strong federal and state oversight of such transactions is crucial to safeguarding patients, communities, and the financial stability of our nation’s health systems.

Here is the list of 17 organizations that signed the letter to the DOJ: 

• AFT: Education, Healthcare, Public Services
• American Economic Liberties Project
• Americans for Financial Reform Education Fund
• Center for Economic and Policy Research
• Colorado Consumer Health Initiative
• Community Catalyst
• Institute for Local Self-Reliance
• Legal Action Center
• National Consumer Law Center (on behalf of its low-income clients)
• NHMH – No Health without Mental Health
• Partners for Dignity and Rights
• People’s Action Institute
• Private Equity Stakeholder Project
• Public Citizen
• Serving at-risk families everywhere, Inc
• Tennessee Justice Center
• Voices of Health Care Action

Read the full letter here.