{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:46:14Z","timestamp":1792622774671,"version":"4.5.0"},"reference-count":67,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Med Care Res Rev"],"abstract":"<jats:p>We evaluate U.S. merger enforcement in the 2020s with a focus on health care merger enforcement under the Biden Administration and the surrounding Trump Administrations. Although federal policymakers across administrations have signaled shifts in enforcement intensity and approach in public statements, when it comes to actual merger challenges in the health care sector, enforcement has been largely consistent. For example, hospital merger challenges have occurred at similar rates dating back to the early 2010s, and have relied on consistent, traditional theories of competitive harm. Enforcement actions in other health care sectors, such as physician services and home health, likewise show continuity, save for a potential shift toward resolving more merger challenges with divestiture agreements under the second Trump administration. Meanwhile, a growing number of states are taking a more active enforcement role through expanded merger-notification requirements and independent challenges of health care mergers and acquisitions.<\/jats:p>","DOI":"10.1177\/10775587261472541","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:53:01Z","timestamp":1790592781000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Health Care Merger Enforcement in the 2020s: Policy Changes and Enforcement Continuity"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8059-2269","authenticated-orcid":false,"given":"Cory","family":"Capps","sequence":"first","affiliation":[{"name":"Bates White Economic Consulting, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leyla","family":"Karakas","sequence":"additional","affiliation":[{"name":"Bates White Economic Consulting, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt","family":"Wohlleben","sequence":"additional","affiliation":[{"name":"Bates White Economic Consulting, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_3_4_2_1","unstructured":"American Medical Association. 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