On March 29, 2023, the West Virginia Governor signed a law that repeals certificate-of-need laws for hospitals and birthing centers. If you’re like most Americans, you’ve probably never heard of “certificate-of-need.” But these state laws make it harder for patients to access quality healthcare.
Certificate-of-need laws are regulations that require healthcare providers to get special permission from the government before adding or expanding healthcare services or facilities. For example, if a hospital wants to add an infant heart center, it has to first prove to the state regulatory board why that center is needed—hence the name, “certificate-of-need,” also known as CON.
The process for approving a CON is lengthy and onerous—and it even allows competitors to make the case for why a CON should be denied. Imagine McDonald’s asking Burger King to open a new restaurant in a town—and Burger King having some say in if that should be allowed. Not exactly a process that will lead to more fast-food options.
Likewise, CON laws make it difficult to add hospitals and healthcare services. In a state like West Virginia, where 53 out of its 55 counties experience healthcare shortages, these laws are even more problematic.
Many state policy organizations have been fighting to remove these burdensome laws so the people in their state can have better access to healthcare services. The Cardinal Institute for West Virginia Policy is one of those organizations—and they played a key role in helping West Virginia lawmakers remove some of the Mountain State’s CON laws during the 2023 legislative session.
Through timely research, op-eds, and other outreach, Cardinal has been educating West Virginia leaders about CON laws and how they hurt West Virginians. State Policy Network worked alongside Cardinal, providing coaching and other resources to help make the case for CON repeal. Cardinal’s years long effort to remove CON laws led to a win in March 2023, when lawmakers repealed some of the state’s certificate-of-need requirements.
The Cardinal Institute explained that the new law removes CON requirements for all hospital services including inpatient services, out-patient services, emergency room services, surgical services, diagnostic and imaging services, and laboratory services provided on a hospital’s campus, and removes the CON requirement for birthing centers. A hospital no longer has to get permission from the government before adding these services—giving West Virginians more healthcare options for their families.
“Research has shown, time and again, that certificate of need laws limit supply, increase cost, and decrease the quality of health care across the country,” said Jessi Troyan, Director of Policy & Research for the Cardinal Institute. “This reform enacted by the Legislature is a vital first step to reverse those trends. I look forward to future efforts that continue to increase access and affordability of health care for all West Virginians.”
Todd Davidson, State Policy Network’s Vice President of Programs, added:
“Certificate-of-need is an arcane policy that only benefits an entrenched interest. It is extremely difficult to repeal. This partial repeal in West Virginia is a big step forward.”
Certificate-Of-Need Laws: Why They Exist And Who They Hurt
State Policy Network
Press Release: Coalition Thanks Policymakers For Repeal Of Certificate Of Need For Hospitals And Birthing Centers In West Virginia
West Virginia Should Eliminate Burdensome Certificate-Of-Need Laws
Cardinal Institute in the Washington Examiner
Convicting Con: Putting West Virginia’s Certificate of Need Laws on Trial