Federal Trade Commission (FTC) staff have reiterated their opposition to the proposed merger between Union Hospital, Inc. and Terre Haute Regional Hospital, L.P. The FTC urged the Indiana Department of Health to deny the hospitals' application for a certificate of public advantage (COPA), which would exempt the merger from antitrust scrutiny.
According to the FTC's comment letter, this second attempt at merging presents similar anticompetitive risks as the original proposal. These risks include increased healthcare costs for patients and decreased wages for hospital workers.
"This repackaged COPA application presents the same problems as before. Competition consistently results in better outcomes for patients and workers than consolidation subject to COPAs," stated Clarke Edwards, Acting Director of the FTC’s Office of Policy Planning. "The Indiana Department of Health should deny this attempt by Vigo County’s only two hospitals to eliminate competition and avoid antitrust review."
The latest comment follows a previous letter from September 2024 that also opposed the COPA proposal. Following this opposition, Union Health and THRH withdrew their initial application in November 2024, an action praised by FTC staff as beneficial for patients and healthcare workers.
In February 2025, Union Health and THRH submitted a revised COPA application with minimal new information. The concerns raised by the FTC in 2024 remain unchanged according to their latest comment letter. The proposed merger is still seen as potentially harmful to competition and consumers due to higher healthcare costs, reduced quality and innovation, limited access to care, and lower wages for hospital employees.
The decision by the Commission to submit these comments was unanimous with a vote of 4-0.
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