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Introduced February 11, 2026 by Elizabeth Warren · Last progress February 11, 2026
Creates new criminal and civil penalties and a civil clawback against corporate insiders, private funds, and affiliates when a change-in-control or other specified triggering event at a health-care company leads to patient injury, death, bankruptcy, or other harms. Bans certain transactions with real estate investment trusts (REITs) for entities receiving federal health program payments, removes certain REIT tax preferences, eliminates REIT dividends from the qualified business income deduction, requires annual public reporting of detailed ownership and control information from health-related entities, and directs an HHS Inspector General study on profit-driven practices in health care. Together the changes increase civil and criminal exposure for executives and investors in health-care buyouts, expand federal disclosure and enforcement tools, change tax treatment for REIT-related health property and dividends, and require a government study of corporate profit practices in health care delivery.
The bill increases transparency, oversight, and potential recovery of funds to protect patients and worker/payroll rights, but does so at the cost of substantial new legal, tax, reporting, and compliance burdens that could disrupt REIT‑based financing, raise costs for providers and patients, and create uncertainty for investors and executives.
Hospitals, health systems, and their employees (including former employees) can recover clawed-back funds to restore unpaid wages, benefits, and pension shortfalls, and communities can receive funds to address local health needs.
Hospitals and other providers that do not sell or newly pledge property to REITs retain eligibility for Medicare/Medicaid and related Federal health program payments, and providers with pre-enactment REIT pledges are protected from sudden payment loss.
Clarifies and simplifies certain REIT qualification and tax-code treatments (including QBI calculation), reducing compliance ambiguity for REITs, advisers, and many taxpayers.
Executives, fund managers, and covered parties face substantial criminal and civil exposure, including retroactive liability reaching back up to 10 years and penalties up to multiple times clawed-back amounts, creating legal risk and financial uncertainty.
Hospitals and clinics that sell or newly pledge property to REITs would lose Medicare/Medicaid payments and may face reduced financing options or higher borrowing costs, risking service reductions, closures, and reduced access to care.
Tax changes remove certain REIT-related tax advantages (including parts of the 199A treatment), increasing taxable income for REIT investors and potentially reducing after-tax returns and investment in REITs.