The California Racial Equity Commission Must Address Gaps in Antitrust Data Collection and Oversight

Last month, Next100’s Nia Johnson presented testimony before the California Racial Equity Commission, a body which aims to address and rectify the impacts of structural racism through strategic recommendations. On September 18, the commission approved a report from its Data Committee, which outlined key issues in how data can perpetuate racial inequities, particularly affecting marginalized communities. The report emphasized the need for improved data visualization, accessibility, and disaggregation. Report findings will be used to guide the development and implementation of the commission’s data framework to better promote racial equity in California, among other efforts.

In her testimony, which you can read below, Johnson highlighted the importance of enhancing data practices to address racial equity in corporate oversight. She urged the commission to recommend that the Office of the Attorney General include racial analysis in antitrust enforcement. Johnson also proposed that corporations, leveraging their resources and reporting requirements, should be held accountable for evaluating and addressing the impact of their actions on communities of color.

Good morning, everyone. I’m Nia Johnson from Next100, a think tank dedicated to amplifying voices from communities often left out of policy decisions. We believe that to make meaningful change, we need to listen to and amplify the experiences of those most affected by policy decisions.

I’m from Oakland, where I’ve seen how corporate consolidation in health care impacts patient care. As a former Medi-Cal patient, I’ve faced issues like delayed services and surprise billing. Now, I’m working to address how corporate practices affect racial equity and worker rights.

After decades of consolidation, service downgrading, labor cuts, and threats of hospital closure, patients and workers at San Jose Regional Medical Center are celebrating a recent monumental win of getting the County of Santa Clara to make an offer to purchase the hospital from HCA, the private equity firm controlling and eroding health care services at the hospital. Up until last month, the critical care of patients in this racially diverse community was under attack and regulators saw no reason to intervene. Had the community not organized and pushed back against the corporate owners, their medical care would not have been rescued.

For-profit companies like private equity firms are buying up health care facilities, overburdening the workers, and often inflating the cost of care. These companies, driven by profit, have even prioritized financial gains over patient care. Tenet Healthcare’s recent acquisition of Bay Area Surgical Specialist Services, which includes over 300 providers in 200 locations, raises further concerns about how this consolidation will impact patients, especially marginalized communities.

If signed by the Governor, AB 3129, which expands the attorney general’s authority to review health care transactions of private equity firms and allows public comment on them before they’re finalized, will be a great first step towards prioritizing patients over profits. It draws on antitrust law, which was designed to curb economic abuses and prevent market manipulation. However, the bill falls short of regulating private hospital consolidation, and antitrust law has also often been applied in a “race-neutral” way, overlooking how corporate consolidation and anticompetitive practices actually contribute to structural racism. The commission has an opportunity to develop data practices that highlight these issues and advocate for antiracist reforms to ensure that our regulatory frameworks address and rectify these disparities.

I urge the commission to recommend that the attorney general’s office integrate racial analysis into antitrust enforcement. This includes examining market definitions, merger reviews, and competitive effects with a focus on racial equity. Additionally, the attorney general’s office should require regulated firms to contribute to racial data collection and analysis, to effectively account for agency resource constraints and ensure that corporations, which already have the resources for data collection and preexisting requirements to report to the attorney general, are held accountable for analyzing and addressing the impact of their actions on communities of color.

We saw during the pandemic how critical funding sometimes failed to reach the communities in greatest need. And so we must proactively safeguard any potential investments in equity from being siphoned off by predatory corporations that might prioritize their bottom line over community needs.

AB 3129 is a good start, and the commission can use it to advance racial equity by developing a data practice framework that can be applied to the public interest standard and extended agency oversight mandated by this bill.

Thank you.