The Doctor’s Revolt: How Oregon Took On Corporate Healthcare

 

The Doctor’s Revolt: How Oregon Took On Corporate Healthcare

By Apirate Monk

In the spring of 2025, Dr. Emily Chen stood in the break room of a Corvallis clinic, staring at a memo pinned to the bulletin board. It demanded shorter patient visits—down to 12 minutes—and quotas for diagnostic tests and specialist referrals. The directive didn’t come from a physician or even a local manager. It was issued by a private equity firm in New York, which had acquired her clinic two years earlier. “This isn’t medicine,” she told a colleague, her voice tight with frustration. “This is a factory.”

Across Oregon, doctors, nurses, and patients were grappling with a healthcare system increasingly dominated by corporate giants—private equity firms, insurers like UnitedHealth Group, and even tech behemoths like Amazon. These entities had swept into the state, buying up independent practices and promising efficiency. Instead, they often delivered higher costs, overworked staff, and care that felt transactional. The public’s anger was palpable, amplified by stories like that of Luigi Mangione, an alleged assassin of a UnitedHealth CEO, whose actions—while universally condemned—tapped into a latent rage against a system many felt was “murdering by spreadsheet.”

But Oregon, a state with a history of bold reform, refused to let corporate control tighten its grip. In June 2025, Governor Tina Kotek signed House Bill 4130, a groundbreaking law that made Oregon the first state to effectively ban private equity and corporate entities from controlling medical practices. The legislation closed loopholes in the state’s Corporate Practice of Medicine (CPOM) laws, outlawed non-compete and non-disparagement clauses, and ensured that only licensed physicians could make decisions affecting patient care. Spearheaded by House Majority Leader Ben Bowman and fueled by grassroots activism, the law has become a potential model for the nation, even as corporate interests scramble to contain its spread.

The Corporate Takeover

The roots of Oregon’s revolt trace back to the 1970s and 1980s, when the U.S. began outsourcing healthcare regulation to large corporations. Health maintenance organizations, managed care, and later the Affordable Care Act’s push for “value-based care” encouraged consolidation, giving rise to vertically integrated giants like UnitedHealth’s Optum. These entities promised to “bend the cost curve” by rationalizing care, but critics argue they prioritized profits over patients. In Oregon, a 1947 CPOM law required medical practices to be majority-owned by licensed physicians, a safeguard against lay control. Yet, by the 2010s, corporate attorneys had found workarounds, using “straw doctors”—physicians who technically owned clinics but were often employees of management services organizations (MSOs) controlled by corporations like Optum or private equity firms.

These MSOs, as Representative Bowman explained, were the linchpin of corporate control. A straw doctor might “own” a clinic on paper, but an MSO—often a subsidiary of a larger corporation—held the real power through management services agreements (MSAs). These contracts allowed corporations to dictate everything from appointment times to staffing models, siphoning profits while bypassing CPOM laws. The result? Clinics were pressured to cut costs, often by reducing Medicaid patients or shortening visits, leaving doctors like Chen feeling like “widgets in a machine.”

The human toll became starkly visible in Eugene, where the Oregon Medical Group, a once-physician-owned practice, was acquired by Optum in 2020. Optum promised minimal changes, but within years, staffing cuts and increased workloads drove 32 doctors to leave. Over 10,000 patients lost their primary care providers, and non-compete clauses prevented many doctors from practicing locally. Elderly patients, some clutching letters from Optum announcing their doctor’s departure, appeared on local news, their stories galvanizing public support for reform. “It wasn’t theoretical anymore,” Bowman told me. “People saw what corporate control did to their care.”

The Fight for Reform

The push for change began in earnest in 2023, when a coalition of physicians, patients, and advocates, including the American Economic Liberties Project, rallied under the banner of “Patients Before Profits.” Dr. Michael Rodriguez, a Salem family physician, became a vocal leader. “We were fighting for the soul of medicine,” he said over coffee in Portland. The coalition’s data showed corporate-owned practices had higher costs and worse outcomes, fueling their case for strengthening Oregon’s CPOM laws.

House Bill 4130, introduced in 2024, aimed to close the straw-doctor loophole and ban restrictive clauses like non-competes, which trapped doctors in corporate jobs, and non-disparagement agreements, which silenced whistleblowers. The bill’s journey was rocky. In Oregon’s 2024 short session, it passed the House and a Senate committee but died due to procedural delays. The Oregon Medical Group debacle, however, shifted the political landscape. By 2025, the bill returned with renewed momentum, driven by stories of patients and doctors—some anonymous, fearing corporate retaliation—flooding Bowman’s office with tales of obstructed care and sidelined careers.

The opposition was formidable but covert. Corporate giants like UnitedHealth, Amazon (through its One Medical acquisition), and private equity firms hired lobbyists to kill the bill quietly, avoiding public testimony that might expose their involvement. One lobbyist, representing a firm with no Oregon operations, admitted to Bowman that their goal was to stop the bill from inspiring other states. “It was a gift,” Bowman recalled, chuckling. “They were scared this would spread.” The American Medical Association, once a foe of healthcare reform, also backed the bill, reflecting a shift among physicians fed up with corporate interference.

Bipartisan support proved crucial. Rural Republicans, like Representative Cyrus T., a dentist, saw firsthand how corporate consolidation closed clinics in their districts, especially those serving Medicaid patients. T. shared the story of a dialysis clinic in his community, shuttered by a private equity firm on 30 days’ notice, forcing patients to drive hours for care—or, in some cases, to give up. “Some decided they’d just let themselves die,” he told colleagues. This resonated across party lines, uniting urban Democrats and rural Republicans in a rare consensus that corporate control was harming constituents.

A National Model?

When Governor Kotek signed HB 4130 in June 2025, it was a triumph for Oregon’s coalition. The law prohibits MSOs from controlling clinical decisions, bans non-compete and non-disparagement clauses, and ensures that professional corporations are majority-owned by licensed clinicians who aren’t MSO employees. It doesn’t outlaw corporate investment outright—clinics can still partner with MSOs for administrative support—but it draws a “bright line,” as Bowman put it, ensuring doctors, not shareholders, make patient-care decisions.

The law’s impact is already visible. In Corvallis, Dr. Chen and her colleagues bought back their clinic with a state-backed loan, part of a program to support physician-owned practices. In Portland, nurses launched a cooperative hospital, a model gaining traction. But challenges loom. Corporate giants may adapt, finding new loopholes, or pull out entirely, as some fear, in a “capital strike” to pressure the state. Bowman is unfazed: “If they leave, it’s an admission their business model depends on controlling doctors. Oregon’s saying we care more about patients than their profits.”

Nationally, the law has sparked interest. States like California and New York are exploring similar measures, inspired by Oregon and Arkansas, where a 2025 law structurally separated pharmacy benefit managers (PBMs) from pharmacies to protect independent businesses. “This is a new way of governing healthcare,” said Hayden Rook Lay of the American Economic Liberties Project. “States are stepping up where the federal government is stuck.” The bipartisan nature of Oregon’s reform, backed by figures like former Governor John Kitzhaber, an ER doctor in his 70s, suggests it’s not just a generational shift but a pragmatic response to a broken system.

For patients like Sarah Nguyen, a Portland teacher who faced a $400 bill for unneeded tests at a corporate clinic, the law offers hope. “I just want a doctor who listens,” she said. For Dr. Rodriguez, it’s a chance to reclaim his profession. But as corporate healthcare giants regroup, the fight is far from over. Oregon’s revolt may be a beacon—or a warning of how hard it is to wrest control from a system built on profit. For now, the state has drawn a line: in medicine, doctors, not corporations, should have the last word.