Last Friday, September 27, the House of Representatives officially published the text of H.R. 9156, the Health Over Wealth Act, introduced in July by Representative Pramila Jayapal (D-WA). This bill would place new requirements on private investment in the health care industry, to include requiring the Department of Health & Human Services to review and approve any mergers/acquisitions of a "health care facility" by a REIT or Private Equity firm.
Argentum is pleased to confirm that the House version of the bill does not include assisted living in the definitions of covered health care entities subject to the bill’s requirements; it is therefore a direct companion of S. 4804 introduced in July by Senator Ed Markey (D-MA). While we were internally confident that both the House and Senate version were the same, as communicated by lawmakers in our outreach, we were not able to officially confirm this until the House of Representatives published the text of the legislation.
We sincerely appreciate all the advocacy efforts by our State Partner, the Massachusetts Assisted Living Association (Mass-ALA), our members, and other stakeholders who helped make this possible. Excluding assisted living from the bill is a direct result of a months-long campaign to raise serious concerns about the consequences of limiting private capital investment in assisted living.
Argentum and Mass-ALA met with Senator Markey’s office following the release of the draft bill to reason why assisted living did not belong with other entities that were initially included in the legislation, and to share the positive impact private finance has on the senior living sector that has yielded quality care and high resident satisfaction. Argentum and Mass-ALA’s meetings were augmented with continued outreach with both Senator Markey’s office and other lawmakers, including Representative Lori Trahan (D-MA), who has been a prominent advocate for assisted living and the lead sponsor of the SENIOR Act. Additionally, Argentum joined with ASHA in sending formal comments to Senator Markey outlining our concerns.
Our message was echoed by an editorial published in the Journal of Health Affairs by a team of academic researchers studying private equity investment in assisted living. The authors urged policymakers to pause and consider the unique structure, financing and history of assisted living before applying the same regulation as other healthcare sectors, stressing that it would be premature to assume that examples of private equity acquisitions in other healthcare sectors is directly applicable to assisted living. The authors also noted that there is no evidence to date that private capital investment in assisted living negatively impacts resident care.
While the legislation is not expected to advance in the remainder of the 118th Congress, it is likely to be reintroduced next session. This is why it was so critical for the current version not to include assisted living, as legislative text that is reintroduced often carries over from previous iterations. It is especially important as private equity is continuing to gain interest from lawmakers and regulators at both the federal and state level; Argentum and our State Partners are regularly monitoring these developments and will similarly counter those efforts.
We will continue to keep you updated on any developments relating to efforts to regulate private investment in health care and our actions to limit the impacts on assisted living.