What happened?

Americans spend about twice as much on healthcare compared to other wealthy nations, and Congress wants to hear directly from Americans why that is. wealthy nations, A congressional panel traveled to Charlotte, North Carolina, on Sept. 14 to question witnesses about why Americans pay so much for health care and struggle to get it. The House Judiciary Committee's Subcommittee on the Administrative State, Regulatory Reform, and Antitrust, chaired by Rep. Scott Fitzgerald (R-WI), held the field hearing under the title "Examining Healthcare Markets: Fraud and Competition." [](#ngr-abfffa68-723a-4523-a715-9edb4e1560f7)

The subcommittee focused on five forces it says drive up costs and limit choices: hospital mergers, state certificate-of-need laws, vertical integration among health systems, insurance fraud, and federal rules it views as anticompetitive. Certificate-of-need laws, common in many states, require health care providers to get state permission before opening a new facility, expanding capacity, or adding certain services.

Why Does it Matter to Me?

The hearing touched on pressures that affect nearly every American with a doctor's bill. Subcommittee Chair Fitzgerald argued that plans sold under the Affordable Care Act (ACA) have risen in price at twice the rate of employer-sponsored plans, a claim he made without citing a specific source during the hearing.

Rep. Harriet Hageman (R-WY) put a human face on the access problem, noting that residents of rural Wyoming sometimes drive 50, 60, or even 100 miles to reach a hospital. That reality, she argued, reflects what happens when markets consolidate and smaller facilities disappear.

Brian Blase, founder and president of the Paragon Health Institute, told the subcommittee that government policies have contributed to consolidation and higher costs. He called for states to repeal certificate-of-need laws, stronger enforcement of hospital and insurer price-transparency rules, and changes to federal policies that govern physician-owned hospitals.

Both sides, now

This was a Republican-led hearing, and the witnesses and questions largely reflected that framing. No Democratic counterarguments were entered into the record from this hearing. The subcommittee's focus on deregulation, removing certificate-of-need requirements, and reducing federal rules reflects an emphasis on competition policy.

On the executive side, President Trump signed two relevant orders. The first, on Feb. 25, 2025, directed federal departments to enforce existing health care price-transparency rules. The second, Executive Order 14267, signed April 9, 2025, directed agencies to identify rules that block competition and share lists of those rules with the Justice Department and the Federal Trade Commission (FTC).

The FTC launched a Healthcare Task Force on March 20 to coordinate enforcement and competition work across the health care sector. A Goodwin Law analysis noted a shift in federal antitrust emphasis between administrations, with the current one placing greater weight on removing regulatory barriers rather than challenging mergers outright.

On the state level, the hearing highlighted a split in North Carolina: Republican lawmakers have pushed to repeal or scale back the state's certificate-of-need system, while Democratic Gov. Josh Stein has opposed a broad repeal.

What happens next?

The hearing record stayed open for five legislative days after Sept. 14, giving subcommittee members time to submit additional written questions and materials. No legislation was introduced or voted on at the hearing. For any policy changes to take effect, Congress would need to pass new laws, or the executive branch would need to act through rulemaking or enforcement. No vote is currently scheduled.

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This article was generated by AI pulling from data. Each article is edited by an editor for accuracy and clarity.

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