When a handful of companies control your grocery bill and your power bill, and private equity firms are buying hospitals and housing, “the market” isn’t setting the price. Corporations are.
This is part of The Squeeze — a five-part series on how Washington’s choices, from tariffs to tax policy to corporate consolidation, are driving up costs for Maine families. Each part looks at one piece of the picture: what’s happening, why it’s happening, and what it’s costing you.
Read part one on the war in Iran, part two on tariffs, part three on the tax code, and part five on how Washington is spending your tax dollars.
By Karin Leuthy and Garrett Martin
Some industries work reasonably well with real competition keeping prices honest. Others, like health care and electricity, were never going to work that way. Nobody comparison-shops an ambulance ride, and building competing power grids doesn’t make sense. Those industries need something different: real public oversight and accountability instead of a marketplace. Either way, the underlying test is the same — is someone actually holding these industries accountable to the public, or are they answering only to their own shareholders? Increasingly, the answer is the latter, and the difference shows up directly in what Maine families pay.
Health care: The oversight that isn’t happening
Hospital and health system consolidation drives up costs, and health care markets are becoming increasingly concentrated. In 2024, one or two health systems controlled more than 75% of inpatient hospital care in 83% of metropolitan areas. When health care markets consolidate, patients pay the price. Fewer competitors give health systems more leverage to demand higher payments from insurers, and those higher prices ultimately show up in higher premiums and out-of-pocket costs. The Trump administration’s antitrust enforcers are fueling more of it, dropping challenges to major mergers and employing a “get out of the way” strategy that puts corporate interests over consumers.
Health care was never going to function like a normal market. It shouldn’t be treated as a commodity and needs strong public oversight and real limits on consolidation instead – not more competition, but real accountability to patients rather than shareholders
The same problem extends to health insurance. In Maine, where premiums rose 30% in the last year alone, just three insurers account for 99% of individual Marketplace enrollment. When insurance markets are this concentrated, lower prices negotiated with providers don’t necessarily translate into lower premiums for consumers. Workers with employer-provided health insurance are vulnerable to rate increases, too. This year, workers are projected to spend an average of $5,297, an almost 8% increase from 2025. Rates are projected to rise another 10% next year on employer plans, pushing the cost per employee to $19,000. Employers pass much of that along through larger paycheck deductions, reduced coverage for family members, and higher bills when care is needed. Health insurers, meanwhile, have collected $371 billion in profit since the Affordable Care Act became law.
Higher drug costs add to the burden. Medicare has begun negotiating prices for some of the country’s most expensive drugs, but the program only covers a fraction of the prescription drug market. Drug companies fighting Medicare’s ability to negotiate lower prices raked in $480 billion in 2024 and returned $67 billion of it to shareholders, while Americans still pay the highest drug prices in the world. The result is a health care system where consolidation and corporate market power leave families with less bargaining power and higher costs.
Utilities: A captive market. A growing bill.
Electricity is a natural monopoly: most households have no competing utility to switch to when rates rise. That makes effective regulation essential. Yet investor-owned utilities have raised electricity rates 49% faster than inflation over the past three years even as the Trump administration promised to lower power bills. For Maine families, there is no alternative for a service that isn’t optional. The regulator is the backstop, and the need for effective oversight is only growing as electricity costs rise.
Groceries and meat: when a few companies set the price
Decades of weak antitrust enforcement have left four retailers controlling nearly 60% of grocery spending nationally, squeezing out small businesses and normalizing higher prices along the way. It’s the same story in meat: four companies control 85% of beef processing. Families are paying record prices for beef today, while at the same time ranchers’ profits are tanking. The extreme concentration of power is reportedly driving 63 farmers a day off their land. Economists estimate corporate consolidation costs the average American household as much as $3,700 a year. That’s a hidden tax that never shows up as a line item but shows up in the total at checkout all the same.
How they keep winning
Consolidation doesn’t just happen once and stop. Companies like Amazon and Walmart use their market dominance and pricing algorithms to squeeze suppliers on what they’re paid while pushing prices up for shoppers, making it harder for competitors to ever get a foothold in the first place. That’s how a handful of companies end up controlling entire categories of what Maine families buy: not by making a better product, but by having enough market power to set the terms for everyone else in the supply chain.
Workers left behind
The same dynamic shows up in paychecks, not just prices. In 1979, CEOs earned about 25 times what their typical worker made. Today it’s closer to 300 times as much. The average Starbucks worker would need to work 18 years to earn what the company’s CEO makes in a single day. It’s not that there isn’t enough money to go around — if Lowe’s had spent the money it used on stock buybacks over the past five years on worker pay instead, every employee could have earned roughly $30,000 more a year. Across the economy as a whole, economists estimate weakened competition has deprived American workers of about $1.3 trillion in labor income each year. For the typical household, that’s a loss of more than $5,000 a year in living standards, on top of what they’re already paying more at the register. Consolidation doesn’t just let companies raise prices on consumers, it lets them shrink the share of profits that go to the workers who help generate them.
No one’s minding the store
None of this is happening by accident. It’s happening because the referees have largely walked off the field. Antitrust enforcement, drug pricing rules, utility rate oversight — these exist precisely to hold industries accountable to the public, whether that means enforcing real competition or, in cases like health care and electricity, applying the direct regulation those industries actually need. When an administration declines to do either, or actively sides with the industries being investigated, corporations don’t just operate without a check. They get to set the terms themselves. Under President Trump and Project 2025 architect Russell Vought, consumer protections have largely been shut down. Corporate offenders are regularly let off the hook, and dozens of key enforcement actions begun during the Biden administration were canceled. These actions, combined with a pattern of lax enforcement, are estimated to have cost Americans over $19 billion.
The result is an economy where a Maine family pays more for groceries, more for electricity, more for health insurance and prescriptions — not because those goods got harder to produce, but because the companies selling them face less accountability than they used to, whether from competitors or from regulators. At its most severe, that kind of lax oversight can cost lives. At a minimum, it’s costing Maine households real money and squeezing small businesses trying to compete against companies that no longer have to compete on price or quality, just on market power.