By Jaimie Cavanaugh, attorney, Pacific Legal Foundation
In a recent column, state Delegate Scot Heckert argues that West Virginia’s Certificate of Need (CON) program is needed to protect health care services in rural communities. Unfortunately, his defense ignores clear evidence that these outdated laws reduce access to care and increase patient costs.
Health care CON laws make it difficult or impossible to open new facilities or offer new services, as existing providers use these regulations to block competition. At one point, every state had health care CON laws. Today, 40% of the nation’s population lives in a state with only one or no CON laws, making it easier to compare their effects.
Research shows that states without CON laws have more rural hospitals and rural surgery centers per capita. One recent academic study found “no evidence that CON repeal is associated with hospital closures in rural areas.” Rural communities were more likely to benefit from repealing CON laws as healthy competition led to expanded access and lower costs. Moreover, allowing more health care facilities to open will create opportunities for future providers to train, ultimately encouraging more workers to enter these fields — boosting job creation while improving patient care.
Other states that have repealed or reformed CON restrictions on health care have seen the benefits. For example, after South Carolina repealed most of its CON laws in 2023, the University of South Carolina announced plans to build a $350 million hospital while the state is planning a new residential juvenile psychiatric treatment facility.
The trend is in the direction of reform: Last week, the Mississippi House of Representatives voted to reform their state’s CON laws to encourage health care providers to launch new services.
As state leaders move to strengthen economic competitiveness and improve the quality of life for West Virginians, repealing CON laws should be a priority to promote competition, access and lower costs.
Jaimie Cavanaugh is an attorney at Pacific Legal Foundation, a public interest law firm that defends Americans’ liberty against government overreach and abuse.
