It’s time to unlock the high quality and lower costs that physician-led hospitals deliver to American patients.
For fifteen years, the Affordable Care Act has handcuffed physician-led hospitals at the request of special interests who promised more options, higher quality, and lower costs in return. The opposite has happened. Meanwhile, every credible study confirms what patients already know — physician-led hospitals deliver better outcomes at lower costs. It’s time to remove the handcuffs.
A growing bipartisan coalition is ready to set patients free.
Two bipartisan bills now moving through Congress would restore patient choice, expand access in underserved communities, and let physician-led care compete on quality and price. PHA is leading the coalition pressing for action this session.
The Physician-Led and Rural Access to Quality Care Act
For a growing number of rural communities, an ambulance may be the only healthcare provider left — yet one potential operator is barred from even trying to open a rural hospital: physicians.
A bipartisan group of members of Congress has co-sponsored H.R. 2191 and S. 1390, which would allow physician ownership of rural hospitals located more than a 35-mile drive from a main patient campus of a hospital or critical access hospital — or 15 miles in mountainous terrain or areas with only secondary roads available.
The bill would also allow grandfathered physician-led hospitals, handcuffed by expansion restrictions since 2010, to expand to meet their community’s needs.
The Patient Access to Higher Quality Health Care Act
H.R. 4002 would repeal the restrictive provisions of Section 6001 of the Affordable Care Act — the special-interest carve-out that prohibited the creation of any new physician-led hospital built after December 31, 2010, and prevented grandfathered facilities from expanding to meet patient demand.
A full repeal would end an arbitrary 15-year experiment that has done nothing but protect entrenched hospital systems from competition. It would restore patient choice, reward quality, and let market-tested, physician-led care expand wherever patients need it most.
Rural Communities Deserve Every Tool to Save Access to Care
A bipartisan coalition of lawmakers and 86 medical organizations agree: it’s time to give rural communities every option to save access to care — including the option of a physician-led hospital. View or share the official PHA one-pager on H.R. 2191 and S. 1390.
When the next hospital is 214 miles away, special interests shouldn’t decide who can build one.
Nearly 700 rural hospitals are at risk of closure. In many rural communities, the local EMS agency is now the only healthcare provider left — placing millions of Americans in healthcare deserts with no timely access to care.
Physicians stand ready to step in. Outdated ACA restrictions stand in the way.
Every community deserves access to the highest-quality, lower-cost care.
Patients in every ZIP code — rural, suburban, and urban alike — deserve real options. Repealing the ban on physician-led hospitals would unleash competition, expand access, and improve affordability for Americans nationwide.
Congress has the power to act. Constituents have the power to make them.
88 Healthcare Stakeholders Agree: It’s time to end the ban.
In October 2025, 88 organizations on the front lines of patient care urged Congress to remove the ACA’s restrictions on physician-led hospitals. The coalition spans physician organizations, specialty societies, state medical associations — and the nation’s second-largest health insurer.
Their message to Congress was clear: lifting these restrictions will expand access, increase competition, and improve affordability for patients nationwide.
A special-interest loophole, hiding in plain sight.
The ACA’s ban on physician-led hospitals didn’t come from doctors, patients, or evidence. It came from special interest lobbyists in Washington who pushed a carve-out designed to stop competition — protecting consolidated hospital systems from the very physicians best positioned to deliver high-quality care. The result is one of the most glaring contradictions in federal health policy.
Anyone Can Own a Hospital — Except a Physician.
A church can own a hospital. A lawyer can. A private equity firm, an insurance company, any corporation, even the federal government can own a hospital. But the individual with the highest level of medical training in the world — a practicing physician — is banned from owning one.
It is the most egregious example of how administrators and special-interest lobbyists wrested control of America’s healthcare system away from physicians and patients. The arbitrary ACA ban on new physician-owned hospitals (and the expansion of existing ones) was sold to Congress on debunked claims about quality and patient selection. The evidence has shown the opposite for fifteen years.
View the Full One-Pager
The Stark Exceptions: Important for Patients.
The federal Stark law contains a number of exceptions that explicitly allow physician ownership — in surgery centers, imaging, physical therapy, value-based arrangements, and more — because in each of these cases, physician leadership is proven to drive better efficiency, higher quality, and stronger outcomes for patients.
Hospitals were once on that list, too. The “whole hospital exception” allowed physician ownership for decades until special-interest hospital lobbyists pushed Congress to strip it out in 2010. Every reason for the other Stark exceptions applies to hospitals. The carve-out has no clinical justification — only a political one.
View the Full One-Pager
A failed experiment built on a broken promise.
The ACA Imposes the Handcuffs
Section 6001 of the Affordable Care Act blocks new physician-owned hospitals and freezes existing ones from expanding — a major concession to incumbent hospital industry lobbyists.
The Promises Don’t Deliver
Opponents argued the restrictions would lower costs and improve access. Fifteen years later, costs have climbed, consolidation has accelerated, and rural and community access has eroded — not the other way around.
It’s Time to Restore Patient Choice
With bipartisan momentum building behind H.R. 2191, S. 1390, and H.R. 4002, Congress has the opportunity to end an outdated restriction that protects entrenched interests at the direct expense of American patients.
Tell Congress: Free patients to choose physician-led hospitals.
