The enactment of SB 613 in West Virginia partially repeals outmoded certificate of need (CON) laws.  When Governor Jim Justice signed the bill into law on March 29, 2023, the state took a positive step toward patient freedom by changing how the state’s CON laws apply to hospitals and birthing centers.  

CON laws are intended to lower costs by reducing duplication of healthcare services, but instead,  they raise costs and lower quality of care.  While partial repeal is helpful, full repeal would have saved $232 per patient per year in total healthcare spending.  

States operating with CON laws are associated with 30 percent fewer hospitals per 100,000 residents across the state.  Additionally, CON states have higher mortality rates following heart attacks, heart failure, and pneumonia than those without CON laws.  A January 21, 2023, Americans For Prosperity report found that states operating under a CON regime deny billions of dollars in new health care investment yearly.  North Carolina denied $1.5 billion from January 2012 - June 2022, Michigan denied $585 million from January 2018 - February 2021, and Iowa denied $250 million from July 2016 - February 2020.

Competition in the marketplace will lower costs with innovation and new technologies, whereas CON laws create unnecessary barriers to entry into the marketplace for new companies and often inhibit existing companies from expanding due to the costly and lengthy application process. CON laws also play into crony capitalism.  Established industry leaders in the marketplace will use CON as a vehicle to block out competition.  This limits access to new healthcare technology and keeps costs high for patients. 

In rural areas of the country, including in West Virginia, CON laws have forced patients to spend more money and use more healthcare services than in states without CON laws.  Rural patients in CON states have higher Medicare spending per beneficiary, hospital readmission rates, ambulance, and emergency room utilization. 

West Virginia’s repeal of CON laws for hospitals and birthing centers is an excellent first step, and lawmakers should strongly consider a full repeal to obtain the full benefits of removing unnecessary layers of bureaucracy in the state’s healthcare market.  CON law repeal is a simple fix to lower patient costs and make healthcare more accessible and affordable.