➤ Key Highlights
The Take Back Our Hospitals Act would bar Medicare payments to facilities controlled by PE firms or REITs.
The Stop Corporate Crimes Against Health Care Act of 2026 would restrict sale-leasebacks and limit related REIT tax benefits.
The Stop MPT Act targets “predatory” sale-leasebacks between health systems and REITs.
Connecticut enacted a law banning hospital sale-leasebacks effective July 1, 2027.
That law also imposes new limits on private-equity involvement in hospital governance.
➤ The Signal
The financing structure under healthcare real estate is now a policy target.
Sale-leaseback risk is migrating from operations to legislation.
Underwriting healthcare net lease now means underwriting political exposure.
For a decade, the sale-leaseback was the engine that turned hospital and care-facility real estate into investable, net-leased product. After high-profile operator failures, lawmakers at both the federal and state level are now treating that structure as a contributor to financial fragility — and writing rules to constrain it.
Connecticut moving from proposal to enacted ban is the inflection. A statute that prohibits hospital sale-leasebacks outright — even with a 2027 effective date — converts a reputational risk into a tangible one, and other states tend to follow first movers on healthcare regulation.
For owners and lenders, this reshapes the risk model. The value of a healthcare net lease has always rested on tenant credit and lease durability; it now also rests on whether the underlying structure remains legal and reimbursable where the asset sits. Jurisdiction is becoming an underwriting input.
➤ Implications
Expect a wider bid-ask in healthcare net lease as buyers price legislative risk by state. Medical-office buildings tied to outpatient and physician demand look more insulated than hospital sale-leasebacks. Governance and structure diligence move to the front of the checklist.
➤ Key Takeaway
The healthcare lease used to be a credit question; it’s becoming a legal one.
Source: Holland & Knight / Sheppard Mullin / CRE Daily — 2026 legislative session
Related on CRE 360 Signal: Washington and the States Move to Outlaw Hospital Sale-Leasebacks
