Bill · H.R. 5433· House(119-HR-5433)
POP Act
- Introduced
- 9/17/2025
- Last activity
- 9/17/2025 — Referred to the Committee on the Judiciary, and in addition to the Committees on Energy and Commerce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Sponsored by
- Val Hoyle
- Cosponsors
- - 5 - 0
- Introduced
- In Committee
What this bill would do
The "Patients Over Profit Act" prohibits health insurance issuers from having common ownership with certain healthcare providers under Medicare. It specifically targets the ownership or control of applicable providers or management services organizations by health insurance issuers. Those in violation must divest their interests within specific timeframes depending on when the acquisition occurred. The bill allows various government officials to bring civil actions to enforce these rules and require the disgorgement of revenue. Additionally, it prevents Medicare Advantage organizations from contracting with the Secretary if they violate these ownership rules.
Yes· 3 of 6
Does this give people more protection from unfair business practices?+6
The bill prevents vertical integration that could lead to unfair practices by prohibiting common ownership of insurers and providers.
Would people over 65 be better off under this?+4
The bill protects Medicare Advantage and Part B providers from ownership conflicts that may impact senior care.
Does this put more money into Medicare, the health coverage for people over 65?+4
The bill directs disgorged revenue from violators into a fund to serve the health care needs of harmed communities.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Revenue for Communities: Revenue taken from violators through disgorgement will be deposited into a fund managed by the Federal Trade Commission to be used for the health care needs of the harmed community (Section 2(c)(3)).
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Prevention of Ownership Conflicts: The bill prohibits a person from both controlling a health insurance issuer and an applicable provider or a management services organization, which limits specific types of common ownership (Section 2(a)).
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Medicare Advantage Protections: For plan years starting on or after January 1, 2026, the Secretary may not contract with a Medicare Advantage organization that has prohibited common ownership (Section 2(g)(1)).
Potential Negative Impacts for People
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Divestment Burdens: Individuals or entities currently in violation of the ownership prohibition are required to divest their interests within one or two years depending on the acquisition date (Section 2(b)).
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Legal and Financial Risks for Entities: Violators may face civil actions, court orders to cease and desist, and requirements to disgorge revenue received from health care services provided during the violation period (Section 2(c)(2)).
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Medicare Advantage Restrictions: Medicare Advantage organizations may be unable to contract with the Secretary if they fall under the prohibited ownership categories (Section 2(g)(1)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Seniors+4Good For Low Income Households+3
- Healthcare
- Increases Medicare Funding+4Improves Healthcare Access+3
- Economy And Finance
- Improves Consumer Protection+6
- Social Issues And Justice
- Improves Poverty Reduction+2
- 10/8/2025
- 2 Cosponsors added.
- 9/17/2025
- Referred to the Committee on the Judiciary, and in addition to the Committees on Energy and Commerce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 3 Cosponsors added.
- Introduced in House
One bill Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
Becca BalintDemocrat · Vermont
Pramila JayapalDemocrat · Washington
Ro KhannaDemocrat · California
Alexandria Ocasio-CortezDemocrat · New York
Patrick RyanDemocrat · New York