A new bill moving through Congress takes direct aim at health insurers. The Patients Over Profits Act would bar carriers and their subsidiaries from owning any Medicare Part B or Part C providers, a move lawmakers say is designed to protect patient care from Wall Street profit grabs.
Supporters argue the measure closes a loophole that’s allowed insurers to purchase local clinics, consolidate providers, and extract profit while patient services decline.
The bill also forces divestitures. Any company failing to comply could face civil action from the Federal Trade Commission, state attorneys general, the HHS inspector general, or the Justice Department’s antitrust chief.
Lawmakers added another twist: the Department of Health and Human Services would be blocked from contracting with Medicare Advantage organizations that also own Medicare Part B or Part C providers. The logic is blunt. By linking ownership to lost revenue opportunities, carriers lose the incentive to buy clinics in the first place.
Rep. Val Hoyle, a Democrat from Oregon’s 4th District, said the situation has become unsustainable.
When you get sick, you should be able to receive the treatment and care that you need. For too long, Wall Street has made that harder by buying up local clinics and care facilities and then focusing on turning a profit instead of delivering care.
Democrat Rep. Val Hoyle, who represents Oregon’s 4th District
Backing Hoyle in the House are New York Democrats Pat Ryan and Pramila Jayapal. In the Senate, Oregon’s Jeff Merkley and Massachusetts’ Elizabeth Warren are pushing the same legislation. They say provider consolidation has spiraled into a national problem.
The bill’s summary points to UnitedHealth Group’s Optum arm as Exhibit A. During a two-year span, Optum spent $31 bn snapping up physician practices, ambulatory surgery centers, and more.
In 2024 alone, UnitedHealth itself purchased stakes in more than 100 surgery centers. The company now directly employs or contracts with about 10% of U.S. physicians and runs over 750 clinic subsidiaries.
According to the sponsors, such expansion erodes price transparency and muddies the line between insurer and provider.
Merkley put it more bluntly: “Your doctor’s office should be in the business of making sure you get the best possible care, not functioning as a profit center for billionaire health care corporations.”
He pointed to one Oregon clinic reportedly shedding dozens of doctors and ejecting thousands of patients after an Optum acquisition.
Insurers aren’t staying quiet. Trade group America’s Health Insurance Plans released a statement defending Medicare Advantage, stressing its importance to more than 35 mn Americans. The group said plans continue to advance reforms that strengthen the program and improve service for members.
