Center for Advancing Health Policy through Research

By Jane Margolies

The trend toward investor ownership is part of a broader national shift in health-care consolidation, said Hayden Rooke-Ley, a senior fellow at Brown University’s School of Public Health. Over the last decade, large non-hospital retailers such as Amazon and Walgreens, along with insurance conglomerates, have restructured to own or manage medical practices, drug distributors and wholesalers.

This piece, authored by Hayden Rooke-Ley, argues that while the Trump administration’s One Big Beautiful Bill Act threatens to gut Medicaid funding by nearly $1 trillion over a decade, states still have powerful tools to protect coverage and even strengthen their healthcare systems. By capping inflated prices in the private insurance market and redirecting those savings to Medicaid—where every dollar is federally matched—states can blunt the impact of federal cuts, support vulnerable providers, and reduce systemic inequities.

On Wednesday, the state House passed Senate Bill 951, the latest effort to expand Oregon’s prohibitions on corporate ownership in local care providers.

Physicians, traditionally less unionized, are aligning with nurses and other healthcare workers due to shared grievances over understaffing, burnout, and corporate cost-cutting practices exacerbated by the pandemic. Hayden Rooke-Ley comments on this trend highlighting his study that found that the number of physician unions formed between January 2023 and May 2024 nearly equaled those established over the previous two decades (2000–2022).

The article discusses the proposed merger of Oregon Health & Science University (OHSU) and Legacy Health, which has drawn significant criticism for potentially violating federal antitrust standards. Advocates argue the merger would lead to excessive market consolidation in Oregon, controlling a majority of hospitals in key regions and potentially driving up healthcare costs without improving access or quality.