Working families in Missouri don’t need another lecture about why health care costs keep going up. They’re living it. Premiums rise. Deductibles get bigger. Employers cut back. Paychecks don’t stretch as far. For years, we’ve been told that this is just how the system works.

But recently, the Trump administration did something important. The U.S. Department of Justice filed a lawsuit against a large hospital system in Ohio called OhioHealth. The reason? The government says OhioHealth used contract tricks to block competition and keep prices artificially high.

That should get Missouri’s attention.

According to the DOJ, OhioHealth required insurance companies to include all of its hospitals in their plans — or none at all. It also used contract terms that limited insurers’ ability to offer lower-cost options to employers and families. In simple terms, if an insurance company wanted access to part of the system, it had to take the whole thing and play by OhioHealth’s rules.

Why does that matter?

Because health care prices aren’t set the way prices are at the grocery store. You can’t walk into an ER and compare prices on a shelf. Prices are negotiated behind closed doors between insurance companies and hospital systems. If an insurance company can say, “Your prices are too high, we’ll go somewhere else,” it has leverage to negotiate lower rates.

But when one hospital system purposely becomes so big that insurers can’t realistically leave it out, that leverage disappears. And if that system also writes contracts that block insurers from steering patients to cheaper options, the market stops working altogether.

When that happens, prices go up. Employers pay more. Workers pay more. Families pay more.

That’s why the Trump administration stepped in. And that’s something Missourians should support.

Free markets only work when there’s real competition. When one dominant player can lock up the field with contract fine print, that’s not free enterprise. That’s corporate muscle.

Now look at Missouri.

New research shows that more than half of all hospitals in Missouri are highly concentrated or monopolies. That same research shows that there are at least 20 hospitals in the state that have an outright monopoly on care in the communities they serve. Furthermore, the last several years have seen high-profile mergers that have made big hospital systems even bigger. 

Big hospital systems aren’t necessarily bad. They provide important care and employ thousands of people. But size brings power. And without clear rules, that power can be used to squeeze insurers, employers and, ultimately, families.

Missouri lawmakers are considering a bill — House Bill 3088 — that would put an end to these kinds of anticompetitive practices. The bill would stop dominant hospital systems from using clauses that block insurers from steering patients to lower-cost providers. It would ban “most favored nation” provisions that prevent insurers from negotiating better deals for their customers. It would limit contract terms that make pricing less transparent.

In plain English, it would stop powerful systems from using fine print to lock out competition and drive-up prices.

This isn’t about attacking hospitals. It’s about protecting Missourians from a rigged marketplace and artificially inflated costs. When a hospital system becomes so dominant that it can dictate terms to everyone else, that’s not a healthy market.

The DOJ’s lawsuit in Ohio shows that the Trump administration recognizes this problem. Missouri shouldn’t wait for its own courtroom battle to take action.

If we believe in free and fair markets, we should defend them. If we believe in competition, we should protect it. And if we believe working families deserve a fair shot, we shouldn’t let corporate contract abuse drive up their health care bills.

The Trump administration took a step. Missouri should follow suit and pass HB 3088.