HR 3017119th CongressIn Committee

Measuring State Healthcare Freedom Act

Introduced: Apr 24, 2025

Standard Summary

Comprehensive overview in 1-2 paragraphs

Measuring State Healthcare Freedom Act would require the Department of Health and Human Services (HHS) to conduct, for 10 years after enactment, an annual, state-level study on health care competition and consolidation. The Assistant Secretary for Planning and Evaluation would lead the effort, with collaboration from the Federal Trade Commission (FTC) Chair and the Assistant Attorney General in charge of the Department of Justice (DOJ) Antitrust Division. The bill directs data collection across multiple dimensions—licensing and credentialing, mergers and acquisitions, state regulatory mechanisms, availability of alternative insurance options, and counts of health care entities—and mandates the calculation of competition metrics like the Herfindahl-Hirschman Index (HHI) for various health care services. It also requires annual, publicly accessible reports and datasets. In short, the bill aims to provide a comprehensive, transparent, government-led view of health care competition and consolidation at the state level to inform policy and oversight.

Key Points

1Ten-year, annual study by the HHS Assistant Secretary for Planning and Evaluation on state-level health care competition and consolidation, beginning after enactment.
2Interagency cooperation: consult with the FTC Chair and the DOJ Antitrust Division; the Assistant Secretary may obtain data from the FTC as needed.
3Broad data metrics include:
4- Licensing requirements for doctors, nurses, and other health care practitioners (licensing processes, ongoing renewal, training/continuing education, residency requirements, board certification).
5- Mergers and acquisitions in hospitals, clinics/outpatient practices, ambulatory surgical centers, health insurers, habilitative service providers, and telehealth.
6- State laws governing mergers (certificates of public advantage) and regulating growth of new health care facilities (certificates of need).
7- Availability of alternative health coverage options (short-term limited duration insurance and association health plans).
8- Counts of key entities (hospitals, medical practices, ambulatory/outpatient practices, ambulatory surgical centers, health insurers, habilitative service providers) at the start and end of each year.
9- The Herfindahl-Hirschman Index (HHI) for specified health care services, calculated area by area in consultation with FTC’s Bureau of Competition.
10Annual reporting and data publication: each year, a status/results report to specified congressional committees, plus public release of the report and interactive datasets on the HHS website.

Impact Areas

Primary group/area affected:- Health care providers and facilities (hospitals, clinics, ambulatory centers, habilitative service providers), health insurers, telehealth providers, and patients/consumers who rely on competitive markets for pricing and choice.Secondary group/area affected:- State health policy environments and planning efforts; researchers and policymakers who use competition metrics to assess market structure and potential regulatory needs.Additional impacts:- Enhanced data transparency and potentially greater scrutiny of consolidation and licensing practices.- Increased interaction between HHS, FTC, and DOJ on data sharing and antitrust considerations.- Administrative burden on HHS to collect, analyze, and publish annual datasets and reports; possible influence on state regulatory debates around COAs and CONs (certificates of public advantage and certificates of need).Certificates of Public Advantage (COAs): state-approved mechanisms that can temporarily relax certain antitrust rules for a merger or acquisition believed to benefit public interests.Certificates of Need (CONs): state-required approvals for expanding or building health care facilities, intended to control growth and ensure need.Short-Term Limited Duration Insurance (STLDI): TT insurance products offering limited coverage and often shorter terms, defined under federal health policy law.Association Health Plans (AHPs): employer-group or association-based plans that may offer an alternative to traditional small-group or individual market coverage.Herfindahl-Hirschman Index (HHI): a concentration measure used in antitrust analysis; higher values indicate less competition (more market concentration).

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