I 
118TH CONGRESS 
1ST SESSION H. R. 2857 
To direct the Assistant Secretary for Planning and Evaluation of the Depart-
ment of Health and Human Services to conduct an annual study on 
health care competition and consolidation at the State level. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 25, 2023 
Mrs. SPARTZ introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To direct the Assistant Secretary for Planning and Evalua-
tion of the Department of Health and Human Services 
to conduct an annual study on health care competition 
and consolidation at the State level. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Measuring State 
Healthcare Freedom Act’’. 
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SEC. 2. ANNUAL STUDY ON HEALTH CARE COMPETITION 
AND CONSOLIDATION AT STATE LEVEL. 
(a) IN GENERAL.—Over each of the 10 years fol-
lowing the date of enactment of this Act, the Assistant 
Secretary for Planning and Evaluation of the Department 
of Health and Human Services (in this section referred 
to as the ‘‘Assistant Secretary’’) shall conduct a study on 
health care competition and consolidation at the State 
level. 
(b) CONSULTATION.—In conducting the study under 
this section, the Assistant Secretary shall consult with the 
Chair of the Federal Trade Commission and the Assistant 
Attorney General in charge of the Antitrust Division of 
the Department of Justice. 
(c) OBTAINING DATA.—The Assistant Secretary may 
secure from the Federal Trade Commission information 
necessary to enable the Assistant Secretary to carry out 
subsection (d)(2). Upon request of the Assistant Sec-
retary, the Chair of the Federal Trade Commission shall 
furnish that information to the Assistant Secretary. 
(d) METRICS.—The study under this section shall in-
clude data collection on each of the following: 
(1) Licensing requirements for doctors, nurses, 
and other health care practitioners, including re-
quirements with respect to— 
(A) initial licensure; 
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(B) ongoing maintenance of licensure; 
(C) specific training and postgraduate and 
continuing medical education; 
(D) residency supervisory requirements; 
and 
(E) board certification. 
(2) Mergers and acquisitions (both vertical and 
horizontal), involving— 
(A) hospitals; 
(B) ambulatory or outpatient practices; 
(C) ambulatory surgical centers; 
(D) health insurance providers; 
(E) habilitative service providers (such as 
providers of physical therapy or occupational 
therapy); and 
(F) telehealth. 
(3) The number of— 
(A) State laws establishing a legal mecha-
nism by which a State approves mergers be-
tween or among two or more hospitals (com-
monly referred to as ‘‘certificates of public ad-
vantage’’); and 
(B) State laws establishing a legal mecha-
nism for regulating the growth of construction 
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of new health care facilities (commonly referred 
to as ‘‘certificates of need’’). 
(4) The availability of alternative forms of 
health insurance coverage, including— 
(A) short-term limited duration insurance 
(as defined for purposes of section 2791(b)(5) 
of the Public Health Service Act (42 U.S.C. 
300gg–91(b)(5))); and 
(B) association health plans (including 
plans offered through the American Farm Bu-
reau Federation). 
(5) The number of each of the following in op-
eration at the start and the end of each year covered 
by the 10-year study period: 
(A) Hospitals. 
(B) Medical practices. 
(C) Ambulatory or outpatient practices. 
(D) Ambulatory surgical centers. 
(E) Health insurance providers. 
(F) Habilitative service providers. 
(6) The Herfindahl-Hirschman Index, within 
geographic areas defined by the Assistant Secretary 
in consultation with the Bureau of Competition of 
the Federal Trade Commission, for the following 
health care services: 
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(A) General acute care hospital services. 
(B) Ambulatory or outpatient medical 
services, disaggregated by medical specialty. 
(C) Habilitative services. 
(e) ANNUAL REPORTS.— 
(1) IN GENERAL.—Not later than the end of 
each of the 10 years referred to in subsection (a), 
the Assistant Secretary shall submit to the Com-
mittee on Energy and Commerce and the Committee 
on Ways and Means of the House of Representatives 
and the Committee on Finance and the Committee 
on Health, Education, Labor, and Pensions of the 
Senate a report on the status and results of the 
study under this section. 
(2) 
PUBLICATION; 
PUBLICLY
ACCESSIBLE 
DATASETS.—Not later than the end of each of the 
10 years referred to in subsection (a), the Assistant 
Secretary shall— 
(A) publish on the website of the Office of 
the Assistant Secretary the report submitted 
under paragraph (1) for the respective year; 
and 
(B) make the data collected through the 
study under this section available to the public 
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on such website in a manner that is publicly ac-
cessible and interactive. 
Æ 
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