Break Up Big Medicine Act
Sponsored By: Senator Sen. Warren, Elizabeth [D-MA]
Introduced
Summary
Breaks common ownership between health care providers and insurers, pharmacy benefit managers, and drug or device wholesalers. The Break Up Big Medicine Act would require companies that own both a provider or management services organization and an insurer, PBM, or wholesaler to divest one side within one year and puts new enforcement and civil tools in place to ensure compliance.
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- Families and patients: Would create a pathway for individuals to sue for damages, including treble (3x) damages and attorney’s fees, and directs disgorged revenues into a fund for health care needs of harmed communities, including overcharged consumers.
- Health care companies and owners: Would require divestiture within one year for violations and allow a divestiture trustee to sell assets if deadlines are missed. The Federal Trade Commission or the Department of Justice must escrow 10 percent of a violator’s profits each month when divestiture milestones are missed.
- Regulators and states: Would give the Federal Trade Commission and the DOJ Antitrust Division primary enforcement authority, permit state attorneys general to sue parens patriae on behalf of residents, require FTC rulemaking, and mandate quarterly compliance reports to Congress.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 1 benefits, 0 costs, 1 mixed.
Ban on health care vertical ownership
If enacted, the bill would make it illegal for a person to own both a health care provider or management services organization and either (A) an insurer plus a pharmacy benefit manager or (B) a drug or device wholesaler. The bill would define who counts as a provider, MSO, PBM, and wholesaler. Owners found to be in violation would need to divest within one year of enactment. The one-year deadline would pause during any Clayton Act section 7A waiting period. The FTC and DOJ would issue guidance within 30 days listing interim divestiture milestones. Any required divestiture would have to be reported to the FTC and DOJ under section 7A even if the usual size thresholds do not apply.
New enforcement and consumer remedies
If enacted, the FTC and the Justice Department would enforce the ownership ban and courts could order violators to stop, divest, and disgorge profits. Disgorged money would go into an FTC-created fund to serve harmed communities and overcharged consumers. If companies miss divestiture milestones, 10% of their monthly profits would be put into escrow and returned only if divestiture happens by the deadline; otherwise the money would go to the FTC fund. A court could appoint a trustee to sell entities if an owner fails to divest. Individuals could sue for damages and seek treble (triple) damages and attorney fees. State attorneys general could sue on behalf of residents and either party could demand a jury trial. The FTC and DOJ would write rules and report quarterly to Congress on compliance and divestitures.
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Sponsors & CoSponsors
Sponsor
Sen. Warren, Elizabeth [D-MA]
MA • D
Cosponsors
Josh Hawley
MO • R
Sponsored 2/10/2026
Roll Call Votes
No roll call votes available for this bill.
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