Elizabeth Warren wants to ‘break up Big Medicine,’ warns insurers will ‘squeeze every penny’ out of you. Is yours? Thomas Kent Wed, November 11, 2026 at 8:15 AM EST 7 min read GC=F +0.14% Andrew Harnik/ Getty Images Moneywise and Yahoo Finance LLC may earn commission or revenue through links in the content below.
Sen. Elizabeth Warren (D-Mass.) renewed her call to break up "Big Medicine" on Nov. 9, warning that the same company can insure you, own your doctor's office, help decide which drugs your plan covers and fill your prescriptions.
"Your health insurer shouldn't own your doctor's office, pharmacy, and the middleman who decides which prescriptions are covered and how much they cost," Warren wrote on X (1).
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"That gives one corporation at least 4 ways to squeeze every penny out of you when you get sick," she added. "Let's break up Big Medicine."
Warren didn't name anyone specifically, but UnitedHealth Group is one example (2). It owns the insurer UnitedHealthcare and the medical provider Optum Health, and Optum Rx, which manages drug benefits and runs its own pharmacies.
Warren and Sen. Josh Hawley (R-Mo.) introduced the Break Up Big Medicine Act (3) in February. The bill has been pending in the Senate Judiciary Committee since then.
The bill would stop the same company from owning both a health insurer or pharmacy benefit manager (PBM) and certain medical providers. PBMs are like middlemen that help insurers decide which prescription drugs their plans cover and how much patients end up paying.
The "Big 3 PBMs" were Caremark Rx, LLC (CVS), Express Scripts, Inc. (ESI), and OptumRx, Inc. (OptumRx), according to the FTC (4).
When the senators introduced the bill, Warren said healthcare companies had created (5) "layers of complexity to jack up the price of everything from prescription drugs to a visit to the doctor."
In a January 2025 report, the FTC found that pharmacies affiliated with the three largest PBMs brought in more than $7.3 billion above (6) what staff estimated the pharmacies paid for certain generic drugs from 2017 to 2022.
The report focused on specialty generics, basically non-brand-name versions of medications used to treat serious conditions like cancer and HIV. Some of those drugs were marked up by hundreds to thousands of percent at affiliated pharmacies.
If you're worried that you might be being overcharged, start with the names on your insurance and prescription cards. If you can't tell who manages your drug benefits, call the number on your card and ask.
Then, ask what you'd pay for the same refill at your usual pharmacy and at the one your plan prefers. Check whether your plan lets you use either one.
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If your employer offers more than one plan, ask each insurer what you'd pay for the same dose and supply of your regular prescriptions at the pharmacy you actually use. Ask whether that price applies before or after you meet the deductible.
Say one plan saves you $40 a month in premiums but charges $60 more for a prescription you fill every month at your usual pharmacy. That's $240 more a year for the lower-premium plan, before you've paid for a single doctor's visit.
If work offers a flexible spending account (FSA), use pretax dollars for predictable expenses you can claim within the plan's deadlines. With an eligible health savings account (HSA), contributions can reduce federal taxable income, earnings can grow tax-free, and withdrawals for qualified medical expenses are tax-free (7).
Many HSAs let you earn interest on cash or invest in mutual funds. IRA Financial has a self-directed HSA (8) that gives eligible savers more options, including real estate and private equity. Those investments can lose value or take time to sell, so it matters if you need the money immediately to pay a medical bill.
For money earmarked for retirement, the company separately offers a self-directed IRA with brokerage access (9).
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If that seems like too much potential risk, a normal HSA can be opened with most banks or credit unions.
If you're shopping for coverage without an employer plan, and aren't eligible for Medicare or Medicaid, check Health Insurance Marketplace plans through HealthCare.gov (10).
If you're on Medicare, you have until Dec. 7 to review your coverage for 2027 (11). Start with the doctors, medications and pharmacies you actually use. A low premium can lose its appeal if a plan leaves your doctor out of network or charges more for a drug you refill every month.
HealthCare.com makes it easier to shop for coverage by connecting you with Medicare plan options available in your area. More than 5 million customers have used HealthCare.com to help find health insurance coverage.
Simply enter your ZIP code to explore available options. If you need help comparing coverage and prices, you can speak with a licensed insurance agent who can answer your questions and help you find a plan that fits your needs and budget.
Once you've chosen your coverage, HealthCare.com lets you enroll the way you want — online or over the phone — so you can complete the process however you prefer.
Finally, it's important to think about not only your health today, but your health in retirement as well.
Price out a typical year and a year when you need more care. If the difference would mean drawing more from your retirement savings, find out how those withdrawals could affect what you have left to live on.
A financial advisor can help crunch the numbers and build a plan that works.
But hiring an advisor can be a lifelong commitment, and it can make or break your retirement. That's why finding reliable advisors is crucial.
That's where Advisor.com can come in. The platform connects you with an expert near you for free.
Advisor.com does the heavy lifting for you, vetting advisors based on track record, client ratios and regulatory background. Plus, their network comprises fiduciaries, who are legally required to act in your best interests.
Enter a few details about your finances and goals, and Advisor.com's AI-powered matching tool will connect you with a qualified expert best suited to your needs.
Finding the right advisor isn't always easy — there's no one-size-fits-all solution. That's why Advisor.com lets you set up a free initial consultation, with no obligation to hire, to see if they're the right fit.
Once you've got the right financial advisor in your corner, the next step is getting a clear picture of where your money's actually going. That starts with the basics — budgeting and tracking your spending.
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X (1); UnitedHealth Group (2); GovInfo (3); Federal Trade Commission (4), (6); Office of Senator Elizabeth Warren (5); Internal Revenue Service (7); Ira Financial (8), (9); Health Insurance Marketplace (10); Medicare (11)
This article provides information only and should not be construed as advice. It is provided without warranty of any kind.
