Certificate-of-need repeal is the key to high-quality, accessible health care

Sep 18, 2025 by AFP

Imagine you live in a rural county, and you have to drive over an hour for medical treatment because the government won’t let new providers open a facility closer to your home.

Why? Certificate-of-need laws.

The good news: More states are repealing these outdated laws, and Americans are better off because of it.

What is CON?

Essentially, CON laws are government permission slips for new hospitals, surgical centers, and medical equipment.

They were sold as a way to control costs, but in reality, they protect big and other established health care facilities from competition.

Families pay the price for this cronyism, with fewer options, longer wait times, and more costly care.

Rather than allowing the market to react to need, the government slows innovation and investment by forcing potential investors through lengthy and costly certificate-of-need processes.

This isn’t a partisan issue, either. Every presidential administration since 1987 has agreed that CON laws “create barriers to entry and expansion, limit consumer choice, and stifle innovation.”

Powerful lobbies and large, established health care providers have a vested interest in keeping CON laws on the books, but some states are fighting back.

States like Florida, Montana, and South Carolina have already acted to roll back CON laws, opening the door to more providers and better care, but there’s still a lot of work to do.

AFP has a track record of successfully fighting these lobbies across the country.

We know opening health care to real competition is critical for your prosperity and our communities’ health.

That’s why AFP has been mobilizing our grassroots army across the country to make CON repeal a nationwide movement to remove outdated barriers, restore accountability, and expand access to affordable care.

This year alone, AFP’s grassroots effort helped deliver CON repeal in Arkansas, the District of Columbia, Kentucky, New Hampshire, Vermont, Virginia, and Wyoming.

These victories build on the progress we’ve driven for years across the country.

That’s not all, though. States like Nebraska and West Virginia aren’t far behind, with high-profile efforts to overturn these regressive policies.

What you can do

Certificate-of-need laws are a perfect example of how government red tape prevents people from getting the care they need. They protect special interests, not patients.

Thanks to your support, we’ve seen recent wins in South Carolina and Wyoming and serious momentum in Nebraska, West Virginia, and more!

Now is the time to keep building. You can help shape the future of health care in your state.

Take a moment to share your story and your opinion in our quick health care survey.

Learn how AFP’s Personal Option health care agenda can put patients and doctors, not bureaucrats and central planners, back in charge.