When Kamala Harris was California's top prosecutor, she was concerned that mergers among hospitals, physician groups, and health insurers could thwart competition and lead to higher prices for patients. If she wins the presidency in November, she'll have a wide range of options to blunt monopolistic behavior nationwide. The Democratic vice president could influence the Federal Trade Commission and instruct the departments of Justice and Health and Human Services to prioritize enforcement of antitrust laws and channel resources accordingly.

Already, the Biden administration has taken an aggressive stance against mergers and acquisitions. In his first year in office, President Joe Biden issued an executive order intended to intensify antitrust enforcement across multiple industries, including health care. Under Biden, the FTC and DOJ have fought more mergers than they have in decades, often targeting health care deals.

"What Harris could do is set the tone that she is going to continue this laser focus on competition and health care prices," said Katie Gudiksen, a senior health policy researcher at University of California College of the Law, San Francisco. The Harris campaign didn't respond to a request for comment. For decades, the health industry has undergone consolidation despite government efforts to maintain competition.

When health systems expand, adding hospitals and doctor practices to their portfolios, they often gain a large enough share of regional health care reso.