Two rival hospitals in Terre Haute, Indiana, have withdrawn their merger application just days before the state was set to rule on the deal. The proposed merger between Union Health and Terre Haute Regional Hospital would have resulted in a single hospital operator for the region. The hospitals sought the merger under a state provision called Certificate of Public Advantage (COPA) law.
The withdrawal came after public backlash and concerns raised by the Federal Trade Commission about the potential negative effects of the merger. Experts have said that COPA laws, which shield hospital mergers from federal enforcement, can harm patients in the long run. Analysts have suggested that state oversight may not be sufficient to mitigate the potential harms of monopolies resulting from hospital mergers.
In a similar case, Ballad Health formed a state-approved hospital monopoly in Virginia and Tennessee, but has struggled to meet quality and charity care goals. Other states have repealed COPA laws, citing growing concerns about their ineffectiveness.
The Union-Regional merger in Terre Haute was years in the making, with Union Health playing a significant role in the passage of Indiana’s COPA law. They now have until July 1, 2026, to refile an application. Overall, the decision to withdraw the merger application highlights the ongoing debate over the impact of hospital mergers under COPA laws.
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