AFP-WV Key Vote Alert: H.B. 2007, Repealing the Certificate of Need Process
Dear Lawmaker:
On behalf of Americans for Prosperity – West Virginia and our activists across the state, I urge you to support House Bill 2007, which would repeal West Virginia’s harmful medical certificate of need laws. We may include these votes in our 2025 legislative scorecard.
The federal government under President Jimmy Carter forced states to establish Certificate of Need (CON) laws out of fear that health care providers would overbuild unnecessary facilities and drive-up health care costs. Decades later, data informs us that CON laws have only served to reduce the availability of essential health care services, increase medical costs, and worsen patient health. CON laws force health care providers to acquire a “permission slip” from government by proving their community “needs” a service before expanding services or capacity. This is why the Reagan administration removed the federal mandate and nearly every Department of Justice under both democrat and republican presidents has called for states to repeal CON their laws.
In essence, we have handed over power to unaccountable bureaucrats who can arbitrarily deny local medical providers the ability to meet a need they see in their community. Even more concerning, the current process has established a mechanism for potential competitors to file an objection to their certificate-of-need application. This stifles expansion of new services in spite of clear health care needs within communities across the state.
According to the Knee Regulatory Research Center at the John Chambers College of Business and Economics at West Virginia University, 88 percent of scholarly research conducted indicates that CON has either no effect or has a detrimental effect on health care. The harmful effects of CON range from low-quality health care to higher costs and lower access to services. This analysis comes from an extensive review of available academic research focused on the impacts of CON laws on health care.
In 2018, President Donald Trump’s administration joined numerous previous administrations in calling for states to repeal their CON laws as a course of best practice, saying, “CON laws have failed to produce cost savings, higher quality healthcare, or greater access to care… There is no compelling evidence suggesting that CON laws improve quality or access…” The Trump administration went on to say:
CON laws can restrict investments that would benefit consumers and lower costs in the long term and are likely to increase, rather than constrain, healthcare costs. This is because CON regimes impose the legal and regulatory costs of preparing an application, then seeing that application through an often-lengthy approval process and potential third-party challenges. As a result, healthcare providers must spend resources on administrative processes rather than on constructing healthcare facilities or delivering healthcare services. In addition, those regulatory costs can be a barrier to entry, discouraging some would-be providers from entering certain healthcare markets, and discouraging some incumbent providers from expanding or innovating in ways that would make business sense but for the costs of the CON system. (Reforming America’s Healthcare System Through Choice and Competition, 2018)
Sadly, despite the overwhelming data in support of repeal, powerful special interests are fighting to keep CON laws in place. That’s because CON laws make it legal for hospital CEOs to collude with government regulators to essentially veto new or expanded health care services they think will compete against them, prioritizing their profits over better access to more quality health care for West Virginia families.
With the mounting evidence that CON laws are harmful, the significant benefits from repeal shown by myriad case studies conducted across the country, and numerous real world examples of how CON has stifled innovation and access to care in the Mountain State, West Virginia lawmakers should be confident that repealing all CON laws to well help Mountaineers access the personalized health care they deserve.
I urge you to support House Bill 2007, Repealing West Virginia’s harmful certificate of need laws. We may include these votes in our 2025 legislative scorecard.
Sincerely,
Jason Huffman
