Health Care Cons: A Survey

One of the cornerstones of IJ’s response to the COVID-19 pandemic has been an invigorated push against certificate of need (CON) laws, which require health care providers to obtain government permission before starting or expanding services. The result of an ill-fated attempt to prevent “oversupply,” CON laws have been slowly falling out of favor as states realize they limit access to health care and raise costs.

This August, IJ released Conning the Competition, a survey of CON laws in the 39 states and other jurisdictions that continue to artificially cap the provision of health care services. The report found no consistency among states’ CON requirements, indicating that established business interests, rather than patient needs, drive the laws. For example, although several states exempt rural areas from CON laws entirely, Nevada requires certificates of need only for hospitals in rural areas.

Conning the Competition will guide IJ’s efforts to challenge these counterproductive laws. The report also complements our new 2021 Initiative, which will offer customized legislative solutions to help state and local governments recover from and rise above the crises of 2020. As documented in the report, 26 jurisdictions suspended CON requirements to increase the supply of medical services during the COVID crisis. IJ will push to make these changes permanent and to persuade new jurisdictions to repeal CON requirements once and for all. After all, it shouldn’t take a pandemic for politicians to prioritize patients over economic protectionism.