Benedic Ippolito and Loren Adler of the American Enterprise Institute identify one topic that could unite partisans on Capitol Hill.

Greater transparency and strengthened antitrust statutes could help reduce the amount of anticompetitive consolidation in health care.

To enhance transparency, legislation could require pre-merger notification to antitrust agencies if the cumulative value of acquisitions by a single parent company in a given market exceeds the reporting threshold, even if the most recent acquisition itself is of lesser value than the threshold (either in general, or specifically for those within health care markets). In conjunction, the threshold amount for reporting mergers and acquisitions could be reduced. This would directly increase the Federal Trade Commission’s (FTC) awareness of smaller mergers, particularly those that cumulatively have substantial impacts on market competition. In addition, the antitrust agencies could be tasked with systematically tracking market concentration levels in each health care market. Together, these two reforms would make it easier for regulators and to assess when more modestly-sized mergers present meaningful competitive concerns. Undertaking these new activities may necessitate additional funding.

Congress could further improve transparency about consolidation levels by making ownership structures clearer and improving existing transparency data that was implemented through rulemaking. Notably, recently proposed legislation would increase the transparency of private equity investments in health care. And the data required of insurers under the Transparency in Coverage rule could be enhanced to include information on the volume of each service that was utilized collectively by each plan’s enrollees.

To limit anticompetitive consolidation and conduct in health care markets, policymakers could also consider strengthening antitrust statutes. A recent testimony by Leemore Dafny, an antitrust expert, included some potential options. For instance, Congress could make it easier to challenge mergers by amending Section 7 of the Clayton Act to require regulators demonstrate that a merger “meaningfully” or “materially” lessens competition or “tends to create a monopoly” rather than “substantially” so.