Bipartisan bill aims to end health conflicts and lower costs in Ohio

The Break Up Big Medicine Act would prohibit health giants from providing and paying for services, in a bid to address rising costs.

Published on Feb. 16, 2026

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A bipartisan bill filed in the U.S. Senate seeks to lower health costs by eliminating incentives for large conglomerates to raise them. The Break Up Big Medicine Act would prohibit companies from owning both medical providers like doctors' offices and pharmacies, as well as insurers and their representatives like pharmacy benefit managers (PBMs). Supporters say this would address conflicts of interest that have driven up prices.

Why it matters

American health spending is the highest in the world, yet outcomes are inferior, leading to suspicions that large conglomerates are profiting without adding much value. The bill aims to restore PBMs to their original role as fighters of high drug prices by eliminating conflicts of interest.

The details

The bill, introduced by Sens. Josh Hawly, R-Mo., and Elizabeth Warren, D-Mass., would empower various government agencies and private parties to sue over violations. It comes as three major conglomerates - UnitedHealth Group, CVS Health and Cigna-Express Scripts - control nearly 80% of insured prescription transactions through their PBM subsidiaries. These PBMs can leverage their position to negotiate rebates that incentivize drugmakers to raise list prices.

  • The bipartisan bill was filed in the U.S. Senate last week.

The players

Josh Hawly

A Republican U.S. Senator from Missouri and co-sponsor of the Break Up Big Medicine Act.

Elizabeth Warren

A Democratic U.S. Senator from Massachusetts and co-sponsor of the Break Up Big Medicine Act.

UnitedHealth Group

A major health conglomerate that owns the largest health insurer, doctors' offices, and a pharmacy benefit manager.

CVS Health

A major health conglomerate that owns an insurer, pharmacies, and a pharmacy benefit manager.

Cigna-Express Scripts

A major health conglomerate that owns an insurer and a pharmacy benefit manager.

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What they’re saying

“There's no question that massive health care companies have created layers of complexity to jack up the price of everything from prescription drugs to a visit to the doctor. The only way to make health care more affordable is to break up these health care conglomerates. Our bill would be a monumental step towards ending the stranglehold that corporate giants have on our broken health care system.”

— Elizabeth Warren (ohiocapitaljournal.com)

“Americans are paying more and more for health care while the quality of care gets worse and worse. In their quest to put profits over people, Big Pharma and the insurance companies continue to gobble up every independent health care provider and pharmacy they can find. Working Americans deserve better. This bipartisan legislation is a massive step towards making health care affordable for every American.”

— Josh Hawley (ohiocapitaljournal.com)

“If you hire a PBM to manage pharmacy spending and network design when they have their own pharmacy that can benefit from the decisions they make, it's an obvious conflict. This legislation aims to restore PBMs to their originally intended role as an unconflicted fighter of high drug prices.”

— Antonio Ciaccia, Drug-pricing expert (ohiocapitaljournal.com)

What’s next

The bill will now move through the legislative process, with the potential for a vote in the U.S. Senate in the coming months.

The takeaway

This bipartisan legislation aims to address the conflicts of interest that have allowed large health care conglomerates to drive up costs and reduce competition, by prohibiting them from owning both providers and payers. If passed, it could lead to more affordable and transparent health care for Ohioans and Americans nationwide.