The Federal Trade Commission on Monday again urged the Indiana Department of Health to deny the application for Union Hospital and Terre Haute Regional Hospital in Indiana to merge.
This is the second attempt by Union Health, which includes Union Hospital, to acquire Terre Haute Regional Hospital. HCA Healthcare owns Terre Haute Regional.
The second attempt under a proposed certificate of public advantage (COPA), presents the same anti-competitive harms as their original application, the FTC said.
"Competition consistently results in better outcomes for patients and workers than consolidation subject to COPAs," Clarke Edwards, acting director of the FTC's Office of Policy Planning, said. "The Indiana Department of Health should deny this attempt by Vigo County's only two hospitals to eliminate competition and avoid antitrust review."
FTC staff warned that the merger poses "substantial anti-competitive risks such as higher healthcare costs for patients and lower wages for hospital workers."
The FTC voted 4 to 0 to submit staff comment to the Indiana Department of Health
WHY THIS MATTERS
On Feb. 11, Union Health said it had successfully submitted a new 2025 Certificate of Public Advantage (COPA) application to acquire Terre Haute Regional Hospital.
"The purpose of the merger is to improve the health and wellness of all Wabash Valley citizens," Union Health said. "Our heightened focus on the health of our community will incorporate improved access to care, health outcome initiatives and continued emphasis on the quality of care. This includes access to primary and preventative care, along with access to robust medical services that include behavioral health, cardiovascular, oncology, neuroscience, women's and children's health, and orthopedic services."
The proposed merger comes in under the wire for state legislation barring such mergers after Feb. 15. But health system officials now must face Indiana Governor Mike Braun, a Republican who has signaled his opposition, according to U.S. News & World Report. Many states are reconsidering their COPA laws that favor hospital monopolies. In 2023, Maine repealed its COPA law, joining Minnesota, Montana, North Carolina and North Dakota, the report said.
THE LARGER TREND
The FTC's latest comment letter follows a similar letter issued in September 2024 opposing the proposed COPA. Following the FTC's opposition, Union Health and Terre Haute withdrew their application in November 2024.
Union Health and Terre Haute submitted a second COPA application in February. The resubmitted application presents little new information, and the concerns the FTC raised in 2024 remain the same, the FTC said.
Email the writer: SMorse@himss.org