The Federal Trade Commission is sharpening its focus on healthcare under the Trump administration, signaling increased scrutiny of hospital consolidation, certificate-of-need laws and other policies the agency has said may limit competition and drive up costs.
FTC Chair Andrew Ferguson said in March that healthcare is a priority for the agency’s enforcement and advocacy work, citing President Donald Trump’s February 2025 executive order aimed at creating a “more competitive, innovative, affordable, and higher quality healthcare system.”
Here are three recent developments hospital leaders should know:
1. A new healthcare task force: The FTC launched a healthcare task force in March aimed at taking a more unified approach to investigating anticompetitive behavior, protecting consumers and identifying emerging risks in healthcare markets.
Mr. Ferguson directed multiple agency divisions — including the Bureau of Competition, Bureau of Consumer Protection and Bureau of Economics — to establish the task force, which will also collaborate with HHS and the Justice Department.
In his memo, Mr. Ferguson cited consolidation and anticompetitive practices as key drivers of higher prices, reduced care quality and stifled innovation. He noted healthcare accounts for roughly 18% of the U.S. economy, while many patients continue to face high costs and limited access.
The unified task force will:
- Lead targeted enforcement and advocacy efforts
- Develop agencywide strategies for investigations
- Proactively identify legal opportunities to influence cases through amicus briefs and statements of interest
- Identify new areas of concern across healthcare
2. Taking aim at certificate-of-need laws: State CON laws were originally designed to prevent the duplication of healthcare services in a specific geographic region, but the FTC has found that these laws “create barriers to entry and expansion, limit consumer choice, and stifle innovation.”
CON laws have come under the crosshairs of the broader Trump administration. CMS has tied some of states’ potential Rural Health Transformation Program funding to certain policies at the state level, including certificate-of-need law repeals.
The funding connection prompted some states, including Tennessee, to move quickly to roll back CON laws. However, Tennessee’s case also prompted a word of caution from the FTC.
As Tennessee lawmakers were working to repeal the state’s certificate-of-need laws, it was also working to repeal Johnson, Tenn.-based Ballad Health’s Certificate of Public Advantage. As originally written, the bills would have seen Ballad’s COPA expire on June 30, 2028, and the state’s CON repeal would not take effect until July 1, 2030.
In an April 1 letter to Tennessee Rep. David Hawk, R-Greeneville, the FTC warned that the gap between the two repeals taking effect could result in what the agency called the “worst possible outcome for patients”: a hospital system that evades antitrust scrutiny at the merger stage by virtue of the COPA, and then evades state regulatory oversight on the back end when the COPA expires.
The FTC urged the state to repeal CON laws “as soon as possible” and no later than the date any COPA expires.
The Tennessee Legislature ultimately reworked the bills. Under the legislation signed into law in May, acute care hospitals seeking to establish in Northeast Tennessee will no longer be subject to CON requirements on June 30, 2028 — the same date the COPA expires — the Johnson City Press reported May 14. Certificate-of-need requirements expire for the rest of the state on July 1, 2030.
3. Expanded premerger rule stalls: In October 2024, the FTC finalized a rule that expanded premerger notification requirements under the Hart-Scott-Rodino Antitrust Improvements Act, which requires organizations to report large transactions to the FTC and Justice Department for antitrust review.
The changes required additional disclosures from merging parties, including more detailed descriptions of business lines, competitive overlaps and certain investor information. The FTC said the updates were intended to reflect shifts in the economy, corporate structures and deal complexity since the HSR Act was enacted nearly five decades ago.
The rule, however, was vacated by a federal judge in February. Eastern District of Texas Judge Jeremy Kernodle said the rule “exceeds the FTC’s statutory authority because the agency has not shown that the rule’s claimed benefits will ‘reasonably outweigh’ its significant and widespread costs.”
The FTC’s rule was opposed by the American Hospital Association, which on May 26 reaffirmed its position that any future changes made to premerger notification requirements should exempt hospitals.
The AHA argued that mergers can help hospitals and health systems navigate mounting financial pressures.
“Given these headwinds, mergers can be economic lifelines for struggling hospitals across America,” Chad Golder, the AHA’s general counsel and secretary, said in a letter to the FTC. “Often, these transactions are the difference between a hospital closing its doors and continuing to provide care to communities. Respectfully, the agencies should be especially wary of chilling these transactions with needless and costly administrative requirements.”
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