2025 State Healthcare Policy Review

In 2025, state legislatures across the country advanced a wave of proposals to rein in the risks of private equity in healthcare. Spurred by hospital closures, bankruptcies, and mounting evidence of financial extraction by private investors, lawmakers in more than a dozen states introduced bills to increase transparency, strengthen oversight of healthcare transactions, and limit practices such as sale-leasebacks and corporate practice of medicine workarounds.

The Private Equity Stakeholder Project has tracked this legislative activity, providing testimony and research to help policymakers understand the financial mechanisms that have contributed to instability in hospitals, nursing homes, and physician practices.

This page provides a snapshot of that legislative landscape. The interactive tracker below lists state bills recently introduced or enacted, while the linked report offers case studies and state-level examples.

In addition to the tracker, the accompanying report provides deeper analysis of this legislative wave. It includes case studies of selected bills – examining their origins and the debates surrounding them. These examples show how states are responding to private equity-driven pressures in healthcare and offer concrete models that can inform future policy efforts.

Key Policy Approaches

State bills addressing private equity and other investor ownership fall into multiple broad categories:

• Transparency and Reporting — Require disclosure of ownership, financing, and control relationships, and advance notice to regulators before transactions close.
• Approval and Enforcement Authority — Empower regulators to approve, condition, or block transactions that pose risks to access, quality, or solvency.
• Targeted Prohibitions — Ban specific financial practices, such as hospital sale-leasebacks or leveraged recapitalizations, that have been linked to financial distress. 
• Corporate Practice of Medicine Enforcement — Strengthen prohibitions against non-clinicians controlling medical decision-making through management service organizations (MSOs). 

Together, these reforms reflect a growing state-level movement to increase accountability in healthcare finance and ensure that business practices align with patient and community needs.

Explore the Tracker

Use the tool below to explore each state’s 2025 legislative activity. You can filter by bill status (Passed, Under Consideration, or Failed) and search by state, policy category, or covered entity. 

For context and analysis, download the complete 2025 State Healthcare Policy Review (PDF). The report covers select states indicated on the map below.