Break Up Big Medicine Act
Sponsored By: Senator Warren, Elizabeth [D-MA]
Introduced
Summary
This bill would require the breakup of vertically integrated health firms by banning common ownership of providers or management services organizations with insurers, pharmacy benefit managers, or drug and device wholesalers. It pairs a one-year forced divestment timeline with new enforcement tools and private legal remedies aimed at returning profits to harmed communities.
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- Families and patients: Providers and management services organizations owned alongside insurers, pharmacy benefit managers, or wholesalers would have to be sold within 1 year, potentially changing who runs local care networks.
- Company owners and regulators: Any person holding those combinations would face mandatory divestiture or penalties. The Federal Trade Commission and the Justice Department would share enforcement power, must issue divestment milestones within 30 days, and can appoint a trustee to sell assets if owners fail to divest.
- Legal remedies and community relief: The bill authorizes private lawsuits with treble damages and attorneys' fees, state attorney general actions, injunctive relief, and disgorgement. Disgorged funds would go into an FTC-created fund to address health care needs of harmed communities.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 1 benefits, 0 costs, 1 mixed.
Ban common ownership across health firms
This bill would ban any person from owning both a health care provider or management services organization and an insurer plus a pharmacy benefit manager. It would also ban any person from owning both a provider or MSO and a prescription drug or medical device wholesaler. Companies violating these bans would have to divest either the providers/MSOs or the insurers/PBMs or wholesalers not later than 1 year after enactment. The bill would define terms like provider, PBM, wholesaler, MSO, health plan, drug, device, and person by reference to existing laws to decide who is covered.
New divestiture rules and penalties
If enacted, the FTC and DOJ would share authority to enforce the bans and must issue guidance within 30 days on divestiture milestones. The 1-year divestment deadline would be tolled while any federal merger-review waiting period is pending. For firms that miss milestones, 10 percent of the firm's profits would be placed into escrow each month; those funds would be returned if divestiture happens by the deadline or put into an FTC-created fund for harmed communities if not. If divestiture still does not occur, a court-appointed trustee could sell the assets. The bill would also allow federal enforcers, state attorneys general, and private plaintiffs to sue for relief, including cease-and-desist orders, divestiture, disgorgement, treble damages, and attorney fees.
Sponsors & CoSponsors
Sponsor
Warren, Elizabeth [D-MA]
MA • D
Cosponsors
Sen. Hawley, Josh [R-MO]
MO • R
Sponsored 2/10/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov