Warren and Hawley Propose Breaking Up Vertically Integrated Health‑Care Giants
Sens. Elizabeth Warren (D‑Mass.) and Josh Hawley (R‑Mo.) are introducing a bipartisan bill to 'break up Big Medicine' by barring large health-care conglomerates from owning multiple links in the care and drug‑payment chain, CBS News reports. The legislation targets firms like UnitedHealth Group and CVS Health that simultaneously control insurance plans, pharmacy benefit managers (PBMs), physician practices and retail pharmacies, arguing this vertical integration lets them manipulate prices, steer patients to their own subsidiaries and squeeze independent providers. Modeled on a 'Glass‑Steagall for health care,' the bill would prohibit a parent company from owning both a PBM or insurer and a medical provider or management services organization, and from combining wholesale drug or device distribution with ownership of providers, and it empowers the FTC, HHS and Justice Department to sue violators and impose financial penalties. Warren and Hawley cite KFF data showing three PBMs—Optum Rx, CVS Caremark and Express Scripts—now process nearly 80% of U.S. prescription claims and are all owned by companies that also run insurers and provider networks. Industry executives have previously defended this model as efficient and consumer‑friendly, but the move reflects growing bipartisan anger over consolidation’s role in high premiums, drug prices and the collapse of independent pharmacies and doctors’ offices.
📌 Key Facts
- Sens. Elizabeth Warren and Josh Hawley are jointly introducing a bill designed to 'break up Big Medicine' by attacking vertical integration in health care.
- The bill would bar a parent company from simultaneously owning an insurer or PBM and a medical provider or management services organization, and from combining drug or device wholesaling with provider ownership.
- It authorizes the FTC, HHS and DOJ to bring enforcement actions and levy financial penalties against health-care conglomerates that maintain prohibited ownership structures.
- UnitedHealth’s Optum Rx and CVS Health’s CVS Caremark are cited as examples of PBMs owned by companies that also operate insurers, physician practices and pharmacies, in a market where three PBMs manage nearly 80% of U.S. prescription claims.
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