A coalition of Congressional democrats has introduced the Patient Over Profits (POP) Act, which directly targets UnitedHealth Group and its subsidiary, Optum. The legislation is designed to restrict large insurance companies like UnitedHealth from acquiring health clinics and practices. Cosponsors of the bill include U.S. Sens. Edward Markey and Alexandria Ocasio-Cortez, supported by Sens. Jeff Merkley and Elizabeth Warren, and Reps. Val Hoyle, Pat Ryan, and Pramila Jayapal.
According to the text of the POP Act, consolidation of clinics and practices by large insurance companies has reduced access, increased costs, and decreased the quality of care for patients. These insurers have integrated healthcare provider groups, surgery centers, and pharmacies to control all aspects of healthcare delivery to patients.
For instance, Optum has spent $31 billion in acquisitions over the past two years, including Corvallis Clinic and Oregon Medical Group. These recent acquisitions have resulted in the loss of staff and access to care for patients. Meanwhile, UnitedHealth acquired over 100 surgery centers in 2024. The company now contracts with 10% of all U.S. physicians and has 750 clinic subsidiaries.
The continual acquisition and aggregation of healthcare facilities has resulted in the loss of local control over healthcare, less autonomy for doctors, conflicts of interest, and lower wages. Higher costs and potential denial of medical treatments are also likely to result from these monopolies, which place increased corporate profits over the needs of patients.
The POP Act has three main components, as follows:
• Prohibits insurers and their subsidiaries from owning Medicare Part B or Part C providers;
• Requires insurers to divest all such acquisitions; and
• Bans the Secretary of the U.S. Health and Human Services (HHS) from contracting with Medicare Advantage organizations that own providers of Parts B and C to disincentivize vertical integration.
Violation of the POP Act would result in civil action against the insurer by the Federal Trade Commission (FTC), state attorneys general, the HHS Inspector General, and the antitrust division of the U.S. Department of Justice (DOJ).
In announcing the bill, its supporters called for the breakup of UnitedHealth to separate its insurance and healthcare businesses. They believe that forcing divestiture is the best way to ensure affordable, accessible, and quality patient care in all communities.
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