Washington, D.C. – In response to Senators Elizabeth Warren and Josh Hawley’s introduction of the Break Up Big Medicine Act, a ”Glass-Steagall“ for healthcare, which would structurally reform vertically-integrated healthcare monopolists along the lines advocated by Economic Liberties’ “Break Up Big Medicine” initiative, the American Economic Liberties Project put out the following statement.
“For decades, policymakers in both parties have incentivized vertical consolidation in health care, resulting in Big Medicine behemoths that exploit conflicts of interest to drive costs up, quality down, and independent providers out of business,” said Emma Freer, Senior Policy Analyst for Healthcare at the American Economic Liberties Project. “This is why we launched the Break Up Big Medicine initiative last year, and we are proud to support the Break Up Big Medicine Act, which will eliminate these conflicts of interest while restoring power over our healthcare system to patients and the providers who care for them.”
The Break Up Big Medicine Act would prohibit insurers, pharmacy benefit managers (PBMs), and wholesale drug distributors from owning medical providers, including pharmacies, or controlling them via a management service organization. In doing so, it would eliminate the conflicts of interest that arise when one parent company is on both or multiple sides of a healthcare transaction. This would bring down costs for patients, employer health plan sponsors, and taxpayers. It would also help empower providers and pharmacists, who are increasingly employed by Big Medicine conglomerates that compromise their clinical autonomy or else compete with them on an uneven playing field.
Economic Liberties has advocated for this kind of structural separation since 2024, in both whitepapers and the popular press. In early 2025, Economic Liberties launched the Break Up Big Medicine initiative to bring together independent healthcare professionals, patient advocates, employers, and policy experts supporting structural changes to the healthcare industry. This coalition has activated for in-person events across the country, from Columbus to New Orleans. The Break Up Big Medicine Act reflects a milestone in this growing movement to lower costs and return power over healthcare to patients and providers.
In December 2024, Senators Warren and Hawley introduced the bipartisan Patients Before Monopolies Act, which would prevent PBMs from owning pharmacies in order to preserve an even playing field for independent pharmacies and lower costs via fair competition. Then, in September 2025, Democrats introduced the Patients Over Profits Act, which would prohibit insurance conglomerates from owning certain Medicare providers, with similar implications. The Break Up Big Medicine Act draws on these concepts while adding provisions related to wholesalers and management service organizations.
Learn more about the Break Up Big Medicine initiative here.
Learn more about Economic Liberties here.
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The American Economic Liberties Project works to ensure America’s system of commerce is structured to advance, rather than undermine, economic liberty, fair commerce, and a secure, inclusive democracy. Economic Liberties believes true economic liberty means entrepreneurs and businesses large and small succeed on the merits of their ideas and hard work; commerce empowers consumers, workers, farmers, and engineers instead of subjecting them to discrimination and abuse from financiers and monopolists; international trade arrangements that promote balanced trade and benefit workers, farmers and small businesses; and wealth is broadly distributed to support equitable political power.