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Senator Elizabeth Warren Urges Elon Musk to Break Up UnitedHealth Group to Reduce Federal Health Care Costs

Senator Elizabeth Warren has called on Elon Musk, head of the newly created U.S. Department of Government Efficiency (DOGE), to consider breaking up UnitedHealth Group, the largest health insurer in the U.S., as part of a broader effort to reduce government spending and improve efficiency.

Concerns Over Health Care Industry Consolidation

In a letter to Musk, Warren highlighted the growing issue of vertical integration in the health care sector, where companies like UnitedHealth not only provide insurance but also control pharmacy benefit managers (PBMs), pharmacies, and physician groups. She argued that such consolidation reduces competition, drives up costs, and burdens government-funded programs like Medicare and Medicaid.

She referenced ongoing federal antitrust investigations and lawsuits against UnitedHealth and other PBMs as part of an increasing push to regulate industry consolidation.

“Over the past four years, antitrust regulators have made significant strides in promoting competition in the health care industry,” Warren stated, citing lawsuits against major PBMs, an investigation into UnitedHealth, and a new ban on noncompete clauses in health care employment contracts.

She urged DOGE to prioritize antitrust enforcement and to support the Department of Justice’s case against UnitedHealth, along with broader efforts to break up monopolistic health care entities.

Bipartisan Support for Health Care Antitrust Action

Warren noted that Republicans have also supported stronger antitrust measures in health care, signaling bipartisan interest in tackling rising costs caused by industry consolidation.

While she did not provide a specific estimate on how much breaking up UnitedHealth would save, she emphasized that increasing competition could lower taxpayer-funded health care costs.

Additional Health Care Cost-Cutting Proposals

Alongside breaking up UnitedHealth, Warren outlined several strategies to reduce federal health spending:

1. Regulating Private Equity in Health Care

   • Warren highlighted that private equity ownership of health care providers has led to price increases of up to 50% for medical services.

   • She called for stricter regulations to prevent private equity firms from inflating health care costs through leveraged buyouts.

2. Reforming Medicare Advantage Payments

   • Warren pointed out that Medicare Advantage plans, which are privately run versions of Medicare, cost the government more than they should due to overpayments and risk score inflation.

   • She estimated that reforming Medicare Advantage payment structures could save over $83 billion per year.

3. Lowering Prescription Drug Prices
   To combat soaring drug costs, Warren proposed:

   • Restricting pharmaceutical companies from extending patents on older drugs to block generic competition.

   • Expanding the government’s ability to use "march-in rights", which would allow federal agencies to produce or authorize the production of high-priced drugs originally developed with taxpayer funds.

She cited research showing that billions in federal health spending could be saved annually through stronger market regulations on drug pricing.

Concerns Over DOGE’s Role in Government Oversight

Despite her recommendations, Warren also expressed skepticism about DOGE’s creation under President Donald Trump’s administration. She raised concerns about its legality, structure, and transparency but acknowledged that cutting government waste is a valid and important goal.

“But your broad point—that the federal government spends trillions of dollars on wasteful spending—is correct,” Warren wrote in her letter to Musk.

Conclusion

Warren’s proposals reflect a growing movement to regulate health care consolidation and limit corporate influence on medical pricing. While breaking up UnitedHealth Group would be a complex and politically challenging process, her letter signals increasing federal scrutiny of how large insurers, PBMs, and health care providers impact taxpayer-funded programs.

With both Democrats and Republicans supporting stronger antitrust enforcement in health care, Warren’s call for DOGE to take action could shape future policies aimed at regulating major health care corporations.