Is Your Healthcare About to Get Radically Cheaper? The Shocking Truth Behind the Bipartisan Break Up Big Medicine Act!

In a significant move aimed at reforming the healthcare landscape in the United States, Senators Elizabeth Warren (D-Massachusetts) and Josh Hawley (R-Missouri) have introduced the Break Up Big Medicine Act. This bipartisan legislation seeks to prohibit the joint ownership of health insurers, pharmacy benefit managers (PBMs), medical providers, and wholesalers, with the goal of reducing healthcare costs and restoring competition within the industry.

The act addresses what both lawmakers describe as structural conflicts of interest that have emerged due to the consolidation of power among large healthcare corporations. These vertically integrated giants often funnel business towards their own affiliates while evading regulatory oversight, a practice that has contributed to rising prices for patients and employers alike. “There’s no question that massive health care companies have created layers of complexity to jack up the price of everything from prescription drugs to a visit to the doctor,” said Warren in a statement. She emphasized that breaking up these conglomerates is essential for making healthcare more affordable.

The proposed legislation would bar parent companies from simultaneously owning medical providers or management services organizations alongside PBMs or insurers. Additionally, companies that possess prescription drug or medical device wholesalers would be prohibited from owning medical providers or management services organizations. Companies found in violation of this law would face automatic penalties, including profit disgorgement and forced asset sales, if they fail to comply within one year of enactment.

The introduction of the Break Up Big Medicine Act comes amidst mounting concerns regarding consolidation within the healthcare sector. Currently, just three PBMs manage a staggering 80% of prescription drug claims in the U.S., while three wholesalers control an overwhelming 98% of prescription drug distribution. This level of vertical integration means that a single parent company can dominate every aspect of the healthcare supply chain—from the insurer that pays for services to the provider that delivers them.

Warren and Hawley previously introduced the Patients Before Monopolies Act, which would have limited parent companies of PBMs or insurers from owning pharmacy businesses. The Break Up Big Medicine Act expands upon this initiative by extending restrictions to additional sectors within the healthcare field. “Americans are paying more and more for health care while the quality of care gets worse and worse,” Hawley remarked. He criticized Big Pharma and insurance companies for prioritizing profits over the needs of working Americans, stating that the new legislation represents a significant step toward making healthcare affordable for all.

To enforce the provisions of this bill, the Federal Trade Commission (FTC), the Department of Health and Human Services (HHS), the Department of Justice (DOJ), state attorneys general, and private parties will be empowered to file lawsuits against companies that violate the law. The FTC and DOJ would also have the authority to review and block future transactions that could re-establish prohibited conflicts of interest.

Emma Freer, a senior policy analyst for healthcare at the American Economic Liberties Project, voiced her support for the legislation, stating, “For decades, policymakers in both parties have incentivized health care consolidation, resulting in Big Medicine behemoths that exploit conflicts of interest to drive costs up, quality down, and independent providers out of business.” The Break Up Big Medicine initiative, she noted, aims to eliminate these conflicts of interest and restore power over the healthcare system to patients and the providers who care for them.

The Break Up Big Medicine Act not only highlights the urgent need for regulatory reform but also serves as a snapshot of the ongoing struggle between corporate interests and the need for accessible, affordable healthcare in the U.S. As lawmakers from both sides of the aisle come together to address these pressing issues, the future of healthcare may hinge on the success of this bipartisan effort.