How Trump could fast-track healthcare mergers

Modern Healthcare – Friday, August 22, 2025
By Alex Kacik

Hospitals and other healthcare organizations pursuing mergers and acquisitions may face fewer regulatory hurdles after President Donald Trump revoked antitrust guidance.

Trump last week withdrew a 2021 executive order on competition issued by former President Joe Biden. The executive order had broadly reaffirmed federal agencies’ role in breaking up monopolies and boosting competition across all sectors of the economy.

The order’s removal signals an ongoing ideological shift from an active oversight philosophy under the Biden administration to the Trump administration’s free-market approach, antitrust experts and merger and acquisition advisers said. However, organizations must still contend with increasingly rigorous state-led merger reviews.

Here’s how the elimination of the executive order could shift industry oversight.

What did the Biden-era executive order say?

The order enlisted federal agencies to promote competition, enforce antitrust laws and update merger guidelines to reverse decades of consolidation across industries — including healthcare.

Biden had specifically called out the widespread use of noncompete clauses, which are contract provisions that prevent employees from joining rival companies, to suppress wage growth and drugmakers exploiting patent laws to stave off generic competitors. These were among a series of anticompetitive trends that limited choices, drove up prices, constrained wages and reduced innovation, the order said.

Barak Richman, a law professor at George Washington University, said the order represented an important policy designed to coordinate agencies’ response to lopsided markets.

“The Biden executive order signaled an all-government approach to competition that was long needed,” he said.

Why did Trump revoke the order?

Trump has been unwinding a number of Biden-era policies he says contradict his administration’s ideology, including some that protected LGBTQ+ people in healthcare settings and extended enrollment for Affordable Care Act insurance exchanges.

While the elimination of the policies may not have an immediate effect, it could pave the way for Trump and his administration to craft regulations that reverse his predecessor’s initiatives.

How did oversight agencies react?

The Federal Trade Commission and Justice Department praised Trump’s move, and described the Biden-era order as an overly prescriptive and burdensome approach to competition policy.

FTC Chair Andrew Ferguson said in a news release the withdrawn order established flawed philosophical hostility to mergers and acquisitions. Markets thrive when they operate freely, he said.

The president’s actions will work in tandem with several other recent deregulation strategies, the Justice Department said in a news release. This includes allowing mergers to proceed by expediting the review process for uncontroversial proposals and settling reviews with divestitures and other consent decrees.

How will eliminating the order affect industry oversight?

Trump’s withdrawal of the order indicates that the administration may be less hostile to businesses looking to grow through mergers and acquisitions, industry observers said. Hospitals and other healthcare companies could spend less time and money battling federal watchdogs over proposed deals as a result, they said.

“This likely means there is more willingness to allow transactions that might’ve died under scrutiny in the past,” said Ken Field, an attorney who specializes in antitrust and healthcare law at the law firm Hogan Lovells. “That sentiment has been borne out in the administration’s willingness to take up settlements and divestitures.”

The agencies already seem to be focusing on more tailored actions, rather than broadly opposing transactions, said Beth Vessel, a healthcare attorney at law firm Holland & Knight who focuses on transactions and antitrust law.

What roles do states play in merger reviews?

Even if federal oversight eases, many states will aim to fill the gaps by ramping up their notification and review laws, experts said.

Attorneys general in many states have taken a more active role in reviewing proposed healthcare deals, sometimes blocking proposals that would cede control to out-of-state companies.

States, including California, Oregon and Minnesota, have enacted laws that give state overseers the power to impose conditions on merger proposals. Some of those laws target corporate investors, such as private equity firms, which are increasingly linked to the healthcare industry.

State-led review processes may pose a greater threat to dealmaking than FTC or DOJ investigations, experts said.

“Hospitals and other healthcare companies are well-advised to consider the enforcement philosophy and history of their state attorney general,” said Jonathan Grossman, an antitrust attorney at law firm Cozen O’Connor.

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