POP Act
House Bill Would Ban Insurers From Owning Medicare Provider Groups Under POP Act
Stalled
No legislative action in over 90 days.
Legislative Progress
Key Points
- Would ban one company (or investor) from owning both a health insurance company and certain Medicare-paid health care providers at the same time.
- Companies already set up this way would have to sell off either the insurance side or the provider/management side within 2 years; new deals would have 1 year.
- Enforcement could come from the Federal Trade Commission, Justice Department antitrust office, the Health Department watchdog, or state attorneys general, through civil lawsuits.
- If a company violates the rule, a court could order it to stop, sell assets, and give back money earned during the violation; returned money would be used to help the harmed community.
- For Medicare Advantage and Medicare drug plans, the government could stop contracting with plans tied to this kind of shared ownership starting with plan years beginning on or after Jan. 1, 2026. Taxes or premiums are not directly changed in the bill.
Impact Analysis
Personal Impact
How this policy affects specific groups of people
Milestones
Referred to the Committee on the Judiciary, and in addition to the Committees on Energy and Commerce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Sent to a congressional committee for expert review. The committee decides whether this bill moves forward.
Introduced in House
The bill was officially filed and given a number. It now enters the legislative queue.
Votes
No votes have been recorded for this legislation yet.
Related News
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Democrats introduce bill to bar payers from owning certain clinics
The Patients Over Profits Act would bar large insurers and their subsidiaries from owning Medicare Part B or C providers. The bill specifically targets vertical integration seen in companies like UnitedHealth's Optum, requiring existing conglomerates to divest or face civil enforcement.
Lawmakers debut bill to bar insurers from buying medical clinics
A new bill would prohibit insurance companies from owning Medicare Parts B and C providers and bar the HHS secretary from contracting with Medicare Advantage organizations that maintain such ownership. The legislation was introduced by Sens. Elizabeth Warren and Jeff Merkley.
Source Information
Document Type
Congressional Bill
Official Title
POP Act
Data Sources
Sponsor
Cosponsors
(5)Analysis generated by AI. Always verify with official sources.