About Bruce Allain, Managing Editor
Bruce Allain, J.D. is the Managing Editor for The Source on Healthcare Price & Competition. Bruce brings two decades of experience in healthcare policy to The Source, having spent years working in government relations and public policy roles for the American Academy of Orthopaedic Surgeons, the American Association of Nurse Anesthesiologists, and AmeriHealth Caritas.State of Texas v. Epic Systems: Heightened Scrutiny of Healthcare Market Dominance Beyond Hospitals and Payers
Bruce Allain, Managing Editor January 15, 2026
Discussions of health care consolidation often center on providers and insurers, but growing concentration among the companies that operate behind the scenes poses equally serious risks. For example, the Change Healthcare data breach in early 2024 caused significant disruptions in healthcare because Change processes approximately half of all U.S. medical claims, and a single cyberattack disrupted large swaths of the health care system. Similar dynamics are playing out in other sectors of the health care system. More than 305 million patients have electronic health records controlled by Epic. At the […]
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Indiana Uses a COPA to Complete Hospital Merger Over FTC and State Attorney General Objections
Bruce Allain, Managing Editor December 15, 2025
On November 9, the Indiana Department of Health issued a Certificate of Public Advantage (COPA) to allow Union Hospital to acquire Terre Haute Regional Hospital. The proposed merger would effectively combine the two only acute care hospitals in Vigo County and create a near‐monopoly for inpatient hospital services in the Terre Haute, Indiana area. The proposed acquisition drew opposition from the Federal Trade Commission (FTC) (under both the Biden and Trump administrations) and the state’s own Attorney General (AG). The COPA prevents state enforcement to challenge the merger as an […]
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A Breakdown of CHA’s Case Against OHCA’s Hospital Spending Targets
Bruce Allain, Managing Editor November 17, 2025
This post is part of our ongoing coverage of the CHA v. OHCA lawsuit. See case page here. In this post, we examine the claims made by the California Hospital Association (CHA) in its recent lawsuit filed against the California Office of Health Care Affordability (OHCA) regarding OHCA’s plan to implement spending targets for hospitals (Case # CPF25519370). While many stakeholders, including CHA, the California Medical Association (CMA), and others, have expressed concerns about the spending targets announced by OHCA and the methodology used to establish them, dissatisfaction with an administrative […]
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The Source’s Katie Gudiksen Co-Authors Report on Hospital Market Competition in Monterey County
Bruce Allain, Managing Editor November 13, 2025
The Source’s executive editor Katie Gudiksen, working with Arnold Analytics, co-authored a report on hospital market competition in Monterey County. The report was released today by California’s Office of Health Care Affordability (OHCA). The study examines why prices at CHOMP, Natividad, and Salinas Valley Memorial are among the highest in the state and finds that limited competition—not higher costs or better quality—is the main driver. It also outlines the impact on local families and employers and offers policy options for the state to consider. Read the full report here: https://hcai.ca.gov/wp-content/uploads/2025/11/OHCA-Investigative-Study-of-Hospital-Market-Competition-in-Monterey-County.pdf.
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California Hospital Association Files Suit Against OHCA Spending Targets
Bruce Allain, Managing Editor October 19, 2025
On October 15, 2025, the California Hospital Association (CHA) filed suit against the California Office of Health Care Affordability (OHCA) (and affiliated defendants) over claims that OHCA’s spending targets are arbitrary, irresponsible and single out hospitals, and will severely disrupt hospital services, starving hospitals of needed resources. The California Legislature created OHCA in 2022 and authorized it: to analyze healthcare markets for cost trends and drivers of spending, to set and enforce cost-growth benchmarks for the state, and to review and assess the impact of mergers, acquisitions, affiliations, and other […]
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New Pre-Merger Notification Requirements Come Under Challenge
Bruce Allain, Managing Editor October 15, 2025
August and September 2025 were active months in the U.S. Chamber of Commerce’s case challenging the Federal Trade Commission (FTC)’s new rules under the Hart-Scott-Rodino (HSR) Act. The FTC finalized changes to the HSR pre-merger notification rules in October 2024, and the Chamber filed suit in January 2025. In August and September, the Chamber moved for summary judgment, the FTC filed a brief in opposition, and most recently, the Chamber filed a brief in support of its summary judgment motion. History of the Hart-Scott-Rodino Act Congress passed the original Hart-Scott-Rodino […]
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Trump Rescinding Biden Executive Order on Competition Indicates New Direction for Federal Enforcement
Bruce Allain, Managing Editor September 15, 2025
On August 13, 2025, President Donald Trump issued an executive order revoking Executive Order 14036 (Promoting Competition in the American Economy) issued by President Joe Biden on July 9, 2021. Biden’s executive order was remarkably lengthy and detailed, addressing many areas with significant implications for healthcare markets and competition. Revoking the order represents a new direction in the Federal Government’s competition priorities. Biden’s Order on Promoting Competition Biden’s 2021 order was unusual in its scope and size, signaling an intention to reinvigorate antitrust enforcement across U.S. industries. The order noted […]
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FTC Announces it Will Not Appeal Ruling Against Noncompete Ban
Bruce Allain, Managing Editor September 8, 2025
On September 5, 2025, the Federal Trade Commission (FTC) announced it would dismiss its appeal of a 2024 court ruling that had determined that the FTC’s attempt at creating a federal noncompete ban had exceeded the FTC’s authority. Ending the legal defense of the noncompete ban effectively ends any chance of the ban going into effect. This saga began on April 23, 2024, when the FTC issued a rule banning many noncompete clauses in employee contracts, which was quickly challenged when several parties filed lawsuits against the rule. On July […]
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Recent Anti-steering Suit Against New York Presbyterian Hospital Mirrors Concerns in DOJ Investigation
Bruce Allain, Managing Editor August 15, 2025
Steering methods, where health plans are able to incentivize patients to choose high-value, cost-effective care can be critical to the financial health of these plans. New York–Presbyterian Hospital is facing mounting legal and regulatory challenges over allegations that it sought to limit competition and prevent insurers from steering patients to lower-cost options. On July 25, 2025, the Cement and Concrete Workers DC Benefit Fund, a self-funded union health plan, filed suit against The New York and Presbyterian Hospital, claiming that New York Presbyterian (NYP) engaged in various anti-steering efforts in […]
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Arkansas Revolutionary PBM Legislation Comes Under Fire
Bruce Allain, Managing Editor July 25, 2025
Update: On Monday, July 28, 2025, U.S. District Court Judge Brian Miller issued a preliminary injunction blocking the law (which would have taken effect on January 1, 2026) until the federal court issues final judgement. In April 2025, Arkansas passed legislation prohibiting pharmacy benefit managers (PBMs) from acquiring or holding a direct or indirect interest in pharmacies. This law makes Arkansas the first state to enact a structural approach to address concerns about PBM business practices. To date, three separate lawsuits have been filed challenging the law. This article looks […]
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