According to KFF Health News, a new bill in the Indiana Senate could reshape hospital consolidation statewide, following the collapse of a controversial merger attempt in Terre Haute. Senator Ed Charbonneau, who co-authored Indiana’s 2021 Certificate of Public Advantage (COPA) law, now seeks to repeal it, citing concerns about hospital monopolies and their impact on patients.

The COPA law, which Indiana adopted as one of 19 states with similar measures, allows hospital mergers that might otherwise be deemed illegal under federal antitrust rules. Proponents argue such mergers can improve health care access and efficiency, while critics, including the Federal Trade Commission (FTC), warn they reduce competition and harm patients by driving up costs and lowering care quality.

Last year, Union Health attempted to acquire Terre Haute Regional Hospital, owned by Tennessee-based HCA Healthcare. The nonprofit health system relied on the COPA law to justify the merger, which would have created a monopoly on acute care in Vigo County. However, the proposal faced backlash from the public and federal regulators. Amid mounting pressure, both parties withdrew their application just days before a state decision was due in December.

Charbonneau now acknowledges missteps in supporting the 2021 law, stating, “I didn’t think I was doing the right thing last time. This time, I believe I am.” His proposed bill would make Indiana the sixth state to repeal its COPA law, joining Maine, Minnesota, and others.

Union Health had been instrumental in drafting the original COPA legislation. Union CEO, Steve Holman, suggested the merger as a solution to Vigo County’s poor health outcomes. However, similar hospital consolidations in other states, like Ballad Health in Tennessee and Virginia, have drawn criticism for unmet promises, including reduced quality of care and missed charity care goals.

If Charbonneau’s repeal succeeds, Union Health would need to reapply for state approval under stricter conditions. The bill is slated for discussion in the legislative session starting January 8, with a potential enactment date of July 1.

Governor-elect Mike Braun has voiced support for reducing health care consolidation, making it a key policy priority. As Terre Haute residents watch the legislative developments, many hope the changes will ensure fairer competition and better health care outcomes across Indiana.

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