Kotek Backs Wyden, Merkley, AOC Bill to Limit Corporate Control in Health Care, but Its Effect on Access and Costs Is Unclear

Oregon — A proposal to extend Oregon-style restrictions on corporate control of medical practices nationwide could give physicians more authority over patient care. Whether it would lead to more clinics, particularly in rural communities, is less clear.

The Stop Corporate Takeovers of Physicians Act, introduced Sept. 16, is modeled on Oregon Senate Bill 951, signed into law in 2025. Gov. Tina Kotek endorsed the federal proposal Monday, saying Oregon’s law offers a model for keeping medical decisions in doctors’ hands.

The federal bill would generally prohibit a medical practice from being owned or controlled by an entity that is not majority-owned and governed by licensed clinicians. It would also restrict management services organizations from controlling practice decisions such as staffing levels, work schedules, billing, prices and contracts with insurers. The proposal includes exceptions to its ownership prohibition for nonprofit and public providers, hospitals, hospital-affiliated clinics, critical access hospitals and rural emergency hospitals.

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Supporters say those restrictions would close arrangements in which a physician owns a practice on paper while an outside company makes its business and clinical decisions. They point to Eugene Emergency Physicians’ dispute with PeaceHealth over a plan to replace the local group with another emergency department staffing company as an early example of physicians using Oregon’s law to challenge a change in control.

The case for protecting clinical independence has some support in the research. A 2023 systematic review published in The BMJ found that private equity ownership of health care providers was often associated with higher costs to patients or payers. Findings on quality were mixed to harmful. The review examined different types of providers and does not establish that banning corporate ownership would improve care at every physician practice.

The bill also would void most clinician noncompete agreements, with an exception for clinicians holding a substantial ownership stake. That could make it easier for a doctor to leave an employer and open a competing clinic nearby. The Federal Trade Commission has warned that physician noncompetes can limit patient choice, especially in rural areas with few providers.

There is a potential tradeoff for independent clinics. Outside investors and management companies can provide financing and administrative services that a small practice may struggle to obtain on its own. The proposed restrictions would narrow the control those partners could receive in return. Whether that protects a rural clinic’s independence or makes it harder to open and sustain one would depend on the clinic’s finances and available alternatives. That is an inference from the bill’s restrictions, not a measured effect of the proposal.

The rural need is substantial. A Physicians Advocacy Institute and Avalere analysis found that rural areas lost nearly 2,500 physicians and 3,300 medical practices from 2019 to 2024. The number of independent rural physicians fell 43%. The figures document a decline, but do not show that ownership restrictions would reverse it.

The federal bill contains no direct funding to open clinics or recruit rural physicians. Its clearest potential effects are on who controls existing practices and whether employed clinicians can leave to compete. Claims that it will increase rural access would require evidence of more operating clinics, available appointments and physicians remaining in those communities after the policy takes effect.