Health Over Wealth Act
Sponsored By: Senator Markey, Edward J. [D-MA]
Introduced
Summary
Reining in private equity control and boosting transparency in health care. This bill would expand federal oversight with licensing, mandatory long‑form reporting, limits on risky REIT deals, escrow and capital requirements, a standing Task Force, and new bankruptcy and hospital‑closure review rules to protect access, quality, and workforce stability.
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- Patients and families: Hospitals would have to notify CMS at least 90 days before service reductions or closures and file a mitigation plan within 15 days. CMS would run a public 45‑day comment period and can delay closures when essential services are at risk.
- Health workers: Covered firms must report staffing, wages, and benefits and would face risk‑mitigation rules that include an escrow to cover operating and capital costs for at least five years and minimum capital investment mandates to support workforce stability.
- Hospitals and communities: Private equity investors would need licenses and pay fees that fund Health Resources and Services Administration workforce programs. Violations can trigger fines up to $10,000 per violation and possible license revocation with divestment requirements.
- Markets and investors: The bill would bar registered investment companies from stripping assets that undermine care and would change REIT tax rules to treat health care property receipts as qualifying rents.
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 4 benefits, 0 costs, 1 mixed.
Stronger rules for hospital closures
This bill would require hospitals to notify CMS at least 90 days before stopping services or closing (30 days after a catastrophic event). Hospitals could not stop essential services during that notice unless keeping them clearly endangered health or safety. If the Secretary finds access would suffer, hospitals must file a mitigation plan within 15 days, the public would get at least 45 days to comment, and HHS could delay closures or require mitigation. HHS may bar Medicare enrollment for the hospital and related owners for up to 3 years in some violations.
Ownership and finance transparency
This bill would require for-profit firms that own health care providers to file detailed reports covering each year of the prior 10 years. Reports would include ownership, debt, fees, related-party deals, staffing and wage changes, patient-care conversions, real-estate leases, political spending, and legal events. HHS (with Treasury and the FTC) would build the reporting system, publish data, audit filings, and send annual reports to Congress on ownership, access, quality, and safety.
Task force to study private equity
This bill would create a Task Force led by the HHS Secretary and a practicing clinician to study private equity in health care. Appointments would be made within 180 days and include experts, patient and worker representatives, and advisory members from the FTC and Justice Department. The Secretary could pause some private equity deals while the Task Force studies risks and the Task Force would direct research on impacts, including possible bans on for-profit ownership.
Bankruptcy and pension protections
This bill would change bankruptcy rules when a health care business reorganizes. Courts would have to give strong weight to keeping regional access, quality, and staff. It would also make ERISA withdrawal liability a top-priority claim in bankruptcy so pension-plan withdrawal obligations are paid ahead of other priority claims.
New rules for investors and REIT deals
This bill would define which firms count as private equity (generally 20%+ owners or control persons) and require PE firms that buy covered health providers to get HHS licenses and pay fees. HHS could require escrows or minimum capital to cover at least 5 years of operating and capital costs, and impose civil penalties up to $10,000 per violation and other penalties tied to federal funding. The bill would bar registered investment companies from asset-stripping health providers, restrict REIT sale/lease deals that would weaken a provider, and change REIT tax rules for health property for taxable years after enactment.
Sponsors & CoSponsors
Sponsor
Markey, Edward J. [D-MA]
MA • D
Cosponsors
Sen. Sanders, Bernard [I-VT]
VT • I
Sponsored 7/23/2026
Sen. Warren, Elizabeth [D-MA]
MA • D
Sponsored 7/23/2026
Sen. Blumenthal, Richard [D-CT]
CT • D
Sponsored 7/23/2026
Sen. Merkley, Jeff [D-OR]
OR • D
Sponsored 7/23/2026
Sen. Baldwin, Tammy [D-WI]
WI • D
Sponsored 7/23/2026
Sen. Booker, Cory A. [D-NJ]
NJ • D
Sponsored 7/23/2026
Sen. Smith, Tina [D-MN]
MN • D
Sponsored 7/23/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov