Certificates of Public Advantage

It has taken a while, but the FTC has spoken out against the anti-competitive effects of Certificates of Public Advantage Laws, those state laws that extend an antitrust shield to merging acute care hospital entities seeking to merge or affiliate in the name of the greater good. COPAs are beyond having a moment and have, over the past few decades, become decidedly fashionable. In light of this, the FTC’s bottom line that the states should stop, turn about face, and repeal these statutes seems curiously pie in the sky. Are COPAs the source of rising health costs and declining competition in the acute care hospital sector or an attempt at a quasi-regulatory fix?