In a new paper published in the Harvard Journal on Legislation Volume 59, Issue 1, The Source’s Jaime King and Katie Gudiksen, together with Erin Fuse Brown, discuss state public option proposals from 2010–2021, including from states like Nevada, Colorado, and Washington. In examining the three main models—(1) Medicaid Buy-In Public Options; (2) Marketplace-Based Public Options; and (3) Comprehensive Public Options—the paper considers potential challenges to these state public option plans and whether they are legally viable and “worth it” for states to pursue, given the goal of improving healthcare …

After months of speculation and opposition from industry groups, the Department of Justice (DOJ), along with attorneys general of New York and Minnesota, filed a lawsuit in federal court in the District of Columbia to block the merger of UnitedHealth and Change Healthcare, just days ahead of the February 27 deadline set for the deal to close. According to the DOJ announcement released on February 24, the lawsuit alleges the proposed $13 billion deal would not only harm competition in commercial health insurance markets, but also the market for technology …

Updated February 23, 2022: The entities withdrew their application and abandoned the proposed merger in the face of federal and state antitrust challenge. A temporary restraining order was granted on February 18 halting merger proceedings pending court ruling on the request for preliminary injunction. Rhode Island’s two largest nonprofit hospital systems, Lifespan and Care New England, will face a challenging road ahead to their proposed merger. On February 17, the Federal Trade Commission (FTC) voted to file a lawsuit to block the proposed merger in court. Separately, Rhode Island Attorney …

Health care consolidation has been on the rise for decades, leading to higher health care prices, not higher quality. Today, two-thirds of hospitals in the U.S. are part of a larger health system; almost 1 in 3 physicians now works in a hospital-owned practice. Many regions are dominated by a single system, leaving patients and families without access to affordable, high-quality care.   Arnold Ventures recently released the second video in a series about high health care prices and the impact they have on health care costs and affordability for …

As states like Nevada, Colorado, and Washington push forward with their state public option efforts, a new article in New England Journal of Medicine, co-authored by Erin Fuse Brown and The Source’s Katie Gudiksen and Jaime King, takes a closer look at the key provisions of each of the plans. The article discusses potential challenges to these state public option plans and most importantly, whether they can effectively improve healthcare coverage and affordability. Listen to Erin Fuse Brown discuss lessons from these states in a podcast for NEJM.

Breaking: A class action lawsuit has been filed in North Carolina state court against HCA Healthcare and Mission Health, alleging anticompetitive practices in violation of the North Carolina Constitution and antitrust and consumer protection laws. The lawsuit follows HCA’s 2019 acquisition of Mission Health in North Carolina, which was approved with conditions by the North Carolina AG, although none of which were competitive impact conditions. Plaintiffs, who are North Carolina patients, claim that Tennessee-based HCA used market power garnered from the cross-market merger to demand anticompetitive terms in contracts with …

In the most recent legislative session, Indiana enacted a new certificate of public advantage (COPA) law (SB 416) that allows mergers of certain hospitals to receive immunity from claims of state antitrust laws for the duration of the certificate. Specifically, hospitals eligible for the COPA must be located in a predominately rural county with a specific population cap and has no more than two hospitals in the statewide comprehensive trauma care system. Indiana joins 17 other states with existing COPA laws and 1 states with limited COPA laws, mostly enacted …

In an encouraging boost to efforts to promote healthcare competition and price transparency, President Biden signed a sweeping executive order that targets consolidation and lack of competition in the healthcare industry, among others. As part of the Executive Order on Promoting Competition in the American Economy released on July 9th, the President targeted specific market players in the healthcare sector, including hospitals, health insurers, and prescription drug manufacturers. The Executive Order affirms the policy of the Biden Administration “to enforce the antitrust laws to combat the excessive concentration of industry, …

On December 10, 2020, the Supreme Court overturned a decision by the Eighth Circuit and upheld an Arkansas Law to regulate pharmacy benefit managers (PBMs).  In a unanimous decision (8-0, Justice Barrett did not participate in the case), the court reaffirmed that state regulation of prices is not preempted by the Employee Retirement Income Security Act of 1974 (ERISA). The ruling in this case found that Arkansas’ law was a price regulation.  In effect, the law required PBMs to reimburse pharmacies at a rate above the price the pharmacy paid …

A new article published in the Milbank Quarterly Opinion proposes the new Biden administration should help states develop capitated public options as part of its health policy agenda, which could lay the groundwork for a federal public option. Authored by Source Advisory Board Member Richard Scheffler and Thomas Rice, the article examines the recent efforts of Washington and Colorado in developing quasi-public options in their states. The authors identify specific states, including California, Massachusetts, and Rhode Island, as being most ready for such a risk-based capitation program. Finally, they call …