On the heels of a scuttled hospital merger between rivals in Terre Haute, Indiana, a state senator introduced a bill that would forbid similar mergers in the future. Last year, nonprofit Union Health tried to acquire the only other acute care hospital in Vigo County by leveraging a state law it helped create that allows hospital monopolies. Now, Sen. Ed Charbonneau, a key architect of the 2021 law, which allows what is known as a 'Certificate of Public Advantage,' or COPA, wants to repeal it.
'I didn't think I was doing 100% the right thing last time,' the Republican, who chairs the Senate health committee, said of co-authoring Indiana's 2021 COPA law. 'I do think I am this time.' Indiana is one of 19 states that have COPA laws, which allow hospital mergers that the Federal Trade Commission otherwise considers illegal because they reduce competition and often create monopolies. In exchange for allowing these deals, the merging hospitals typically agree to meet a number of conditions imposed by the state to mitigate the harms of a monopoly. But health care economists and the FTC have said that state oversight cannot replace competition and that these mergers ultimately harm patients. The public and the FTC pressured Indiana health regulators to block Union's merger with its rival, Terre Haute Regional Hospital. Just days before a December deadline for the state to issue a decision on whether to approve the deal, Union Health and Terre Haute Regional Hospital pulled their application. Union Health and Tennessee-based HCA Healthcare, which owns Terre Haute Regional, declined to answer questions about what prompted the decision to scuttle the deal. In a November statement, Union said it planned to submit a new application. In 2021, Union Health leaders were instrumental in the passage of Indiana's COPA la