Relates to health insurance and provider divestment

◆ The sponsor's argument

Why Michelle Hinchey says this is needed

When an insurance company owns a healthcare provider, it can create serious conflicts of interest. Too often, the company prioritizes profits over patient care, reduces patient choice and access, and engages in anticompetitive practices like steering patients to affil- iated clinics. This business model often leads to increased administra- tive burdens for both providers and patients and can leave non-affiliat- ed providers trying to compete in a marketplace that is essentially rigged for the insurance company and its providers. This is because when healthcare providers, insurers, and other entities merge, they gain substantial market power. This consolidation can reduce competition and lead to monopolistic practices. With fewer competitors, such "vertically integrated" organizations can increase prices for services, medications, and insurance premiums, placing a heavier finan- cial burden on patients. In addition, this model often limits whom doctors can refer patients to, based on an insurance company's preference for medical providers that it owns or that are in its network. This inherent conflict for providers owned by insurers begs the question: "Will my doctors fight as hard for the best outcome for me when they are dealing with the insurance company that they ultimately work for?" UnitedHealth Group owns UnitedHealthcare, the largest insurer in the United States. In the Hudson Valley, it acquired health care provider CareMount Medical in 2022, followed by Crystal Run Healthcare in 2023. Prior to that takeover, Crystal Run went on a shopping spree of its own, gobbling up numerous medical providers in the region. The final outcome of these consolidations is obvious: If there are fewer health care providers, patients will have fewer choices. If there is less competition, prices will eventually increase. Health care workers will also have fewer options for where they can work. This bill prohibits an insurance company from owning a health care provider or a health care provider from owning an insurance company. It is a critical step in preventing the corporate consolidation of health care that results in a reduction in the quality and availability of care.

This is the sponsor's own case for the bill, quoted from their memorandum. It is not Agora's description of what the bill does.