POP Act
Sponsored By: Senator Jeff Merkley
Introduced
Summary
Bans common ownership between health insurers and certain health care providers. The Patients Over Profit Act would bar anyone from owning or controlling both a health insurance issuer and an applicable provider or its management services organization, and would require divestment, enforcement, and Medicare program compliance rules to enforce that ban.
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- Families and patients: Would aim to reduce incentives for insurer-owned providers to steer care and would direct disgorged revenue into an FTC-created fund for harmed community health needs.
- Applicable providers: Entities that violate the ban must be divested within 2 years if acquired before enactment or within 1 year after acquisition. The bill excludes hospitals, critical access hospitals, rural emergency hospitals, durable medical equipment suppliers, prosthetics and orthotics suppliers, and pharmacies.
- Insurers and Medicare programs: Would bar Medicare Advantage contracts and payments for plan years beginning on or after January 1, 2026 for organizations tied to covered providers, require MA plans to certify compliance, and treat payments to violators as false claims. Enforcement can be brought by the HHS Inspector General, DOJ Antitrust, the FTC, or State attorneys general and courts can order divestiture and disgorgement.
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Bill Overview
No Economic Impacts Identified for this Bill
Sponsors & CoSponsors
Sponsor
Jeff Merkley
OR • D
Cosponsors
Elizabeth Warren
MA • D
Sponsored 9/17/2025
Edward Markey
MA • D
Sponsored 9/17/2025
Roll Call Votes
No roll call votes available for this bill.
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