Congress moves to break up insurer-provider ownership to restore healthcare competition
S. 2836 — POP Act · Filed by Jeff Merkley (D-OR) · 2 cosponsors · Introduced Sep 17, 2025 · Referred to committee
Your members of Congress
Enter a ZIP to see where your representative and both senators stood on this bill.
Looked up on this device — your ZIP is never stored on our servers.
What it does
This bill prohibits any company or person from simultaneously owning a health insurance company and a healthcare provider (such as a doctor's office or clinic) that serves Medicare patients. Companies already in violation have 2 years to divest one or the other; new violations have 1 year. The bill empowers the FTC, DOJ, state attorneys general, and HHS to sue for enforcement, and requires Medicare Advantage and Part D plans to certify compliance or lose federal payment.
Why we flagged it
The bill's core mechanism is a structural prohibition on vertical integration between insurers and providers—a classic antitrust remedy designed to eliminate conflicts of interest and restore competitive market conditions in healthcare.
What the text implies
- Divestment may trigger significant M&A activity and market consolidation as companies choose which business line to retain, potentially creating short-term disruption in healthcare delivery.
- The bill's definition of 'applicable provider' excludes hospitals, critical access hospitals, rural emergency hospitals, DME suppliers, and pharmacies—leaving those vertical integrations untouched and potentially creating competitive asymmetries.
The full analysis lists 5 implications of this text.
Who stands to gain
independent healthcare providers and physician practices; standalone health insurance companies without provider networks; healthcare consumers through reduced conflicts of interest and lower prices