AHA Comments on DOJ Anticompetitive Deregulations RFI

May 23, 2025

The Honorable Abigail Slater
Assistant Attorney General
Anticompetitive Regulations Task Force
Antitrust Division
U.S. Department of Justice
950 Pennsylvania Ave. NW
Washington, DC 20530

Re: Anticompetitive Regulations Task Force Press Release (Dkt. ID ATR-2025-0001-0002)

Dear Assistant Attorney General Slater and Task Force Members:

On behalf of the American Hospital Association’s (AHA) nearly 5,000 member hospitals, health systems and other health care organizations, and our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and the 43,000 health care leaders who belong to our professional membership groups, we appreciate your invitation to submit comments identifying regulations that make health care markets less competitive.

The AHA shares the Trump administration’s belief that the “ever-expanding morass of complicated Federal regulation imposes massive costs on the lives of millions of Americans, creates a substantial restraint on our economic growth and ability to build and innovate, and hampers our global competitiveness.”¹ And we share the Department of Justice’s (DOJ) belief that “unnecessary anticompetitive regulations put affordable healthcare out of reach for millions of American families.”² We therefore welcome the opportunity to comment on the laws and regulations that make it harder for hospitals and health systems to compete fairly in the health care marketplace — which DOJ rightly identifies as one of the “markets that ha[s] the greatest impact on American households.”

As we submit these comments, we are mindful that this is, in many ways, well-trodden ground. In 2018, the first Trump administration issued a report entitled Reforming America’s Healthcare System Through Choice and Competition (2018 Report), which correctly observed that “many government laws, regulations, guidance, requirements and policies… resulted in healthcare markets that lack the benefits of vigorous competition. Increasing competition and innovation in the healthcare sector will reduce costs and increase quality of care—improving the lives of Americans.”³ Seven years later, the AHA starts from that exact premise. Many of the issues identified in that 2018 Report remain or have worsened, and many new challenges have emerged. Then, as now, the U.S. health care system imposes a bewildering array of regulations on hospitals and health systems, adding significant administrative costs, disincentivizing pro-competitive arrangements, and promoting vertical consolidation of large commercial insurers to the detriment of patients and providers across the country.

In this letter, we provide an overview of the key statutes and regulations that have impeded competition in the health care market and offer a series of recommendations to remedy these obstacles. We first outline the key areas of regulation that have permitted commercial insurers to limit market competition, narrow consumer choice and undermine access to health care for Americans — all while avoiding true accountability under the nation’s antitrust laws. We then describe other categories of regulations that limit the ability of hospitals and health systems to compete in the market, including those that impose undue administrative burdens, inhibit the expansion of telehealth, limit growth within the health care workforce and generally inflict large costs on the health care industry without corresponding benefits.⁴

Download the full letter.

1. Executive Order 14192, Unleashing Prosperity Through Deregulation (Jan. 31, 2025).
2. Press Release, Justice Department Launches Anticompetitive Regulations Task Force (March 27, 2025).
3. U.S. Departments of Health and Human Services, Treasury, and Labor, Reforming America’s Healthcare System Through Choice and Competition (2018) at 16-17.
4. AHA separately submitted comments incorporating many of these suggestions to HHS, CMS, and OMB as part of the parallel effort to reduce burdensome regulations. May 12, 2025, Letter from AHA to Secretary Kennedy, Administrator Oz, and Director Vought re Request for Information: Deregulation (FR Doc. 2025-06316) https://www.aha.org/lettercomment/2025-05-12-aha-response-omb-deregulation-rfi