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.
The Patients Over Profit Act would prohibit health insurance companies and certain healthcare providers from being owned or controlled by the same company or person. The bill targets potential conflicts of interest where a company might profit by limiting care through its insurance arm while owning the provider delivering that care. Companies currently in violation would have two years to sell either their insurance business or their healthcare provider operations, while new acquisitions would have one year to comply. Federal regulators including the Federal Trade Commission, Department of Justice, and state attorneys general can enforce the law through civil lawsuits, and courts can force violators to divest their businesses and return profits earned during the violation period. The legislation also applies these restrictions to Medicare Advantage and Medicare Part D plans starting in 2026, with violations treated as false claims under federal fraud law.
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