Antitrust Enforcement Under Siege: Pay-to-Play Operation Hobbles Biden's Leftover Case

Antitrust enforcement, once a promising start under the second Trump administration, has devolved into a pay-to-play operation. Influential MAGA lobbyists, paid millions by large corporations, use their clout with the president and Attorney General Pam Bondi to overrule enforcers and push through mergers. As a result, cases prosecuted but unresolved in the Biden years are under threat, with the latest settlement allowing the UnitedHealth Group monopoly to swallow Amedisys, the second-largest provider of home health care in the nation.

Key Takeaways:

• The Justice Department's Antitrust Division has allowed UnitedHealth Group, a colossal monopoly, to purchase Amedisys, the second-largest provider of home health care in the nation, with minimal divestitures.
• The divestitures, involving 164 home health and hospice locations in 19 states, will be bought by BrightSpring and Pennant, both owned by private equity firms with a history of allegedly illegal conduct.
• KKR, BrightSpring's owner, was sued by the Antitrust Division in January for failing to notify about mergers with standard filings.
• Pennant's parent company had to settle with DOJ over discrimination violations.
• The divestitures are unlikely to restore competition, as former Antitrust Division chief Jonathan Kanter demonstrated that more than one-third of such remedies fail to do so.
• The $1.1 million fine imposed on Amedisys for lying about providing "true, correct, and complete" responses in premerger filings is a mere fraction of the $3.3 billion transaction value.
• One of UnitedHealth's lobbyists, Ballard Partners, has close ties to the Trump White House and Attorney General Pam Bondi.
• The Tunney Act, created to prevent outside interference in enforcing antitrust laws, could be used in an evidentiary hearing to determine the role of lobbyists in the UnitedHealth-Amedisys deal.
• Democrats in Congress are raising opposition to the settlement, citing concerns over price increases, reduced access for patients, and suppressed wages.

Statistics:

• UnitedHealth Group will retain 75% of Amedisys' home health and hospice locations after the divestitures.
• The $1.1 million fine imposed on Amedisys is approximately 0.03% of the $3.3 billion transaction value.
• Over $3.5 billion has been spent by KKR on lobbying in the United States since 2018.
• UnitedHealth Group's lobbying expenses in the first half of 2025 alone exceeded $2 million.

Sources:

• https://prospect.org/power/2025-07-29-law-could-blow-open-trump-antitrust-corruption/
• https://prospect.org/justice/2025-07-29-doj-maga-lobbyist-bidding-shutters-another-antitrust-case-bondi-ballard/
• https://prospect.org/health/2023-12-20-building-a-giant-unitedhealth/
• https://www.nytimes.com/2025/07/28/health/unitedhealth-backlash.html
• https://prospect.org/topics/david-dayen/
• https://www.justice.gov/opa/pr/justice-department-requires-broad-divestitures-resolve-challenge-unitedhealths-acquisition
• https://storage.courtlistener.com/recap/gov.uscourts.mdd.571263/gov.uscourts.mdd.571263.198.2_2.pdf
• https://www.economicliberties.us/press-release/dojs-unitedhealth-group-amedisys-settlement-is-a-win-for-big-medicine-and-a-loss-for-hospice-patients-and-nurses/
• https://www.healthcaredive.com/news/unitedhealth-amedysis-sell-home-care-hospice-brightspring-pennant-group/747145/
• https://www.semafor.com/article/09/16/2024/dojs-jonathan-kanter-says-agency-will-overhaul-how-it-reviews-bank-deals