(C) Ohio Capital Journal
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As Trump tries to fire them, antitrust officials continue to investigate the medical sector • Ohio Capital Journal [1]
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Date: 2025-04-02
President Donald Trump is trying to fire two members of the Federal Trade Commission. But on Monday night they said they’re continuing their work to root out anticompetitive practices by health care companies.
Then on Tuesday came news that some of their work against insulin manufacturers could be unraveling as a result of Trump’s actions.
Commissioners Rebecca Kelly Slaughter and Alvaro Bedoya appeared in a virtual health care roundtable aimed at highlighting ways in which corporate concentration in that sector is driving up prices and hurting patients.
The event was sponsored by the group Fight Corporate Monopolies. And it appeared that part of the purpose was to show that Slaughter and Bedoya were still on the job as they fight Trump in court. Critics say the president’s attempt in March to fire the Democratic commissioners was a corrupt favor to tech billionaires who bankrolled Trump’s campaign and his inauguration.
Monday’s roundtable had to do with concerns Trump himself has expressed — that huge health care conglomerates are using middlemen and other practices to drive up the cost of drugs and other care.
Alvaro Bedoya, who was appointed to the FTC by former President Joe Biden, said increasing corporate control of the health sector is partly responsible for the fact that Americans pay by far the most for care, yet have among the worst health outcomes among developed nations.
“The state of American health care is shameful and embarrassing — the impact it has on regular people,” he said. “It’s shameful and embarrassing what happens when people get a cancer diagnosis. They’re forced to fundraise from friends and family as many of them go bankrupt. It’s shameful and embarrassing that life expectancy in this country is years (less) than what it could be. It’s even more embarrassing that people living paycheck-to-paycheck have even more years taken away from them.”
He added, “It’s hard to look at the system and not see that at least some substantial part of those problems are caused by concentration and consolidation in the health care industry.”
Among the things Bedoya and Slaughter did to get a grasp of the situation was in 2022 to order a study of the conduct of pharmacy middlemen known as pharmacy benefit managers. The biggest three are part of the conglomerates UnitedHealth Group, CVS Health, and Cigna-Express Scripts. They handle nearly 80% of the insured drug transactions in the United States.
Last July, the FTC released an interim report saying that the companies appeared to be improperly pushing up prices and hurting patients. Then in October, the FTC sued them on allegations that they were gouging patients who needed insulin to stay alive.
But by early Tuesday evening came word that the FTC’s general counsel was staying that suit, possibly because there aren’t enough commioners with undisputed standing to hear it.
“Today, the General Counsel of the FTC stayed the administrative adjudication of the Commission’s case against the three largest pharmacy benefit managers (PBMs) over the price of insulin,” Slaughter and Bedoya said in a joint statement. “He, not any sitting commissioner, took this action; there are no Commissioners available at the FTC to adjudicate this case as a result of the Trump Administration’s attempt to remove us. Sadly, this was an entirely foreseeable consequence of illegally attempting to fire the minority Commissioners.”
They added, “The American people deserve a fair and timely adjudication of the serious allegations in the FTC’s complaint. We strongly object to the pause in this matter. Here, justice delayed will be justice denied. It is hard to think of a matter that is more important.”
During Monday’s roundtable, Utah pharmacist Sheldon Birch described other problems in the pharmaceutical space. He said pharmacies such as his have no choice about signing the contracts the big pharmacy middlemen put before them. Birch said the reimbursements he gets under those contracts make it hard to stay in business.
“We see a massive transfer of wealth from Main Street to Wall Street,” he said. “It’s a problem. I’m a capitalist. I own businesses. But we need to have some help so we can have a playing field that is fair… Help me keep my small business alive. Help keep the dollars and cents on America’s small-town main streets.”
Slaughter, who took a Democratic seat on the FTC during Trump’s first term, said the antitrust laws the agency is supposed to enforce are intended to stop unfair flows of cash from Main Street to Wall Street.
“The law does not contemplate that,” she said. “This isn’t what the law was designed to protect.”
Carmen Comsti of National Nurses United said harm caused by corporate concentration extends beyond pharmacy. She said the 2019 purchase of non-profit hospital Mission Health in Asheville, N.C., by for-profit HCA Healthcare harmed the residents of a rural region.
HCA closed a cancer center, a wheelchair clinic, primary-care clinics, and it reduced charity care, geriatric services, security and hospital chaplains at the western North Carolina facility, Comsti said.
“It’s not just what health care systems are doing to get market control,” she said. “It’s what they’re doing to our communities with that power.”
Deb Keaveny, a Minnesota pharmacist, said it’s important for Trump to keep politics out of antitrust enforcement.
“We are deeply concerned about the administration’s recent decisions,” she said, “Americans need reassurance that the FTC can and will stop anticompetitive practices in the corporate monopolization of health care. This isn’t a partisan issue and the removals (of Bedoya and Slaughter) put ongoing studies, investigations and actions in jeopardy and weaken enforcement.”
Bedoya seemed eager to get back to a sole focus on his day job.
“My hope is that we can get back to normal and start pushing this work forward,” he said.
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