The US Federal Trade Commission (FTC) has requested the Indiana Department of Health again to reject an application submitted by Union Hospital (Union Health) to acquire Terre Haute Regional Hospital (THRH).
In a comment letter, FTC staff reaffirmed their opposition to the plan of the hospitals in Terre Haute, Indiana to merge under a Certificate of Public Advantage (COPA), warning that the deal would significantly harm competition in the region.
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According to the FTC, the merger would likely lead to higher healthcare costs for patients, reduced quality of care, diminished innovation, and lower wages for hospital staff.
Union Health and Terre Haute Regional Hospital, the only hospitals in Vigo County, first filed their COPA application in 2024.
The proposal aimed to shield the merger from federal antitrust scrutiny by seeking state approval.
However, the FTC opposed the plan in September 2024, prompting the hospitals to withdraw their application in November— a move that the Commission described as a win for patients and healthcare workers.
Despite the earlier setback, Union Health submitted a renewed COPA application in February 2025.
In its latest comment, the FTC stated that the new application contains little additional information and fails to address the concerns previously raised.
The FTC’s four commissioners voted unanimously to submit the staff’s comment to the Indiana Department of Health.
FTC Office of Policy Planning acting director Clarke Edwards said: “This repackaged COPA application presents the same problems as before. Competition consistently results in better outcomes for patients and workers than consolidation subject to COPAs.
“The Indiana Department of Health should deny this attempt by Vigo County’s only two hospitals to eliminate competition and avoid antitrust review.”
