AFPF-North Carolina Releases New Study Revealing Devastating Impact of CON Regulations on Health Care

Apr 8, 2025 by AFP

Raleigh, NC—Americans for Prosperity Foundation-North Carolina (AFPF-NC) released a new report revealing how North Carolina’s Certificate of Need (CON) law blocked nearly $3 billion in health care investment in three years.

In North Carolina, CON laws onerously require health care providers to obtain approval from the Department of Health and Human Services before acquiring, replacing, or adding facilities, services, or equipment. The laws have proven to be costly and delay or deny progress in expanding health care options for North Carolinians.

Comparing the data to AFPF-NC’s 2022 findings, the Foundation has now reported in updated studies that North Carolina has denied twice as much health care investment in the last three years than the previous decade. According to AFPF Investigative Analyst Thomas Kimbrell: 

“The state’s CON law prevents many providers from ever applying to offer services they otherwise would. North Carolina has the most expensive health care of any state. Interest in health care investment in the Tar Heel state is at an all-time high; however, the result of so much lost health care is that North Carolinians pay higher prices for less access and lower-quality health care.”

North Carolina’s legislature is taking up the issue with the Senate Health Committee passing Senate Bill 370 last week, repealing many CON regulations and examining the effectiveness of the rules.

AFP-NC State Director, Tyler Voigt, responded to the Foundation’s findings and noted:

“This new report from AFP Foundation shows the depth to which CON laws prevent competition and limit what care is available for North Carolinians. It’s time we remove the barriers constraining health providers from delivering lower costs and better healthcare outcomes. As the state’s leader in grassroots advocacy, AFP-NC is encouraged to see the momentum in the Senate around SB 370. With the House introducing a companion bill in HB 455, we are hopeful that 2025 is finally the year to eliminate CON.”

CLICK HERE to read the full report.

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