OhioHealth Settlement And White House Report Signal Broader Federal Focus On Restrictive Hospital Contracting

The proposed OhioHealth consent decree resolves DOJ antitrust allegations against OhioHealth but may be less an isolated resolution than the beginning of a broader enforcement trend. Filed just weeks after the DOJ brought a nearly identical suit against the NewYork-Presbyterian hospital system, and paired with a related White House economic analysis released within days of the settlement, the resolution marks a coordinated effort by the Trump administration to challenge dominant hospital systems over contracting practices that constrain health plan network design options.

The White House Council of Economic Advisers report, released days after the OhioHealth settlement, provides the economic rationale that could underpin further enforcement or legislative action. The report estimates that a nationwide ban on anti-steering, anti-tiering, and all-or-nothing bundled contracting could reduce hospital and affiliated-physician prices by approximately 18% and yield roughly $45 billion in annual employer-sponsored insurance premium savings.

Two significant recent developments illustrate the Trump administration’s increasing focus on policing of hospital contracting practices that limit health plan network design flexibility. On June 16, 2026, the U.S. Department of Justice (DOJ) Antitrust Division and Ohio attorney general filed a proposed consent decree resolving their civil antitrust suit against OhioHealth. (Prior Alert) Two days later, the White House Council of Economic Advisers (CEA) released a memorandum quantifying the potential economic effects of a broader ban on the types of contracting restrictions at issue in the OhioHealth case and the DOJ's parallel suit against NewYork-Presbyterian. This alert updates our prior coverage of the OhioHealth complaint and summarizes both developments.

The Proposed OhioHealth Consent Decree

On June 16, the DOJ Antitrust Division and Ohio attorney general filed a proposed consent decree resolving their civil antitrust suit against OhioHealth. The settlement would resolve the DOJ and Ohio AG’s suit against OhioHealth from February 2026, alleging that OhioHealth used its market power in the Columbus, Ohio area to impose anticompetitive contractual provisions on commercial health insurers in violation of Section 1 of the Sherman Act and Ohio’s Valentine Act. Specifically, the complaint targeted provisions that: (i) required payors to include OhioHealth in every network at the most favored benefit level; (ii) prohibited payors from offering enrollees financial incentives to choose lower-cost providers; and (iii) prevented payors from informing enrollees of price differences between OhioHealth and competing providers.

If approved by the court, the proposed consent decree would:

• Void any existing OhioHealth contract provisions that prohibit, deter, or penalize steering, tiered plan designs, or price transparency.
• Prohibit OhioHealth from seeking or obtaining such provisions in future payor contracts.
• Prohibit OhioHealth from penalizing insurers that offer budget-conscious plan designs, including narrow networks, tiered networks, and reference-based pricing arrangements.
• Require a court-appointed compliance monitor for five years, with OhioHealth obligated to submit compliance reports every 45 days as well as quarterly reports on new or amended payor contracts.

OhioHealth did not admit wrongdoing and would pay no financial penalties. The proposed decree is subject to a 60-day public comment period and final court approval.

The White House CEA Report: Framing the Broader Enforcement Theory

On June 18, 2026, the White House Council of Economic Advisers released a memorandum examining the economic effects of anti-steering, anti-tiering, and all-or-nothing bundled contracting, the same categories of contracting restrictions at the center of the OhioHealth and NewYork-Presbyterian enforcement actions. The timing of the report, released just two days after the consent decree, suggests the administration may view the OhioHealth resolution not as a conclusion but as a proof of concept, with the report making the economic case for extending these restrictions industry-wide.

The CEA examined three contracting mechanisms that dominant hospital systems may use to limit competitive pressure: (i) anti-steering clauses, which prevent health plans from offering enrollees financial incentives to choose lower-cost providers; (ii) anti-tiering clauses, which require health plans to place the hospital system in the most favorable cost-sharing tier regardless of price; and (iii) all-or-nothing bundled contracts, which requires health plans to accept all of a system’s hospitals and affiliated physicians in network or otherwise include none at all in their networks.

The CEA estimates that a nationwide ban on these practices could reduce hospital and affiliated-physician prices by approximately 18% (with a plausible range of 11 to 26%) in directly affected markets, averaging around $4,100 per inpatient admission. On the premium side, the report estimates that employer-sponsored health premiums could fall approximately 6.5% in directly affected markets, yielding savings of approximately $1,755 per family and $606 per individual annually, and generating national aggregate premium savings of approximately $45 billion per year.

What to Watch

With the OhioHealth proposed consent decree now on file and the CEA analysis providing a detailed economic case for eliminating these contracting practices, attention turns to DOJ’s case against NewYork-Presbyterian. NewYork-Presbyterian has publicly stood behind its contracting practices while casting blame on payors. Whether that system elects to continue to contest the DOJ’s allegations or pursue a negotiated resolution will be an important signal as to the trajectory of this enforcement trend.