Gov. Josh Shapiro highlighted a single type of owner for scrutiny — private equity, which he said "has infected our health care system" and treats Pennsylvania hospitals like "a piggy bank they can empty out and smash on the floor." A private equity-only approach would create a carve-out for the state's numerous and powerful nonprofit health systems, including UPMC, the state's largest private employer. These systems are represented by a powerful lobby that publicly opposed a proposal last session.