Reforming West Virginia’s CON Laws

West Virginia has had crisis after crisis imposed on it; some have come externally, but many have been so tragically self-inflicted. The best example of this cycle is how our certificate of need a.k.a. CON laws have hampered our ability to respond to any of the health issues our state has experienced.


History of Reforming CON Laws

At the heart of CON laws is the lie that state boards and centralization can direct scarce resources. CON laws started out of the technocratic period of the 70’s when people were concerned that overspending in some areas would deprive other places of medical care. At the same time, they worried that consumers would pay more for the surplus hospital beds.

History has not been kind to this assertion, and I am hopeful this revelation will be a springboard to more freedom and choice in healthcare for West Virginians. Everyone will benefit from a future in the Mountain State filled with choice, freedom, and high-quality health care.

Dozens of CON law reform efforts have come up across multiple states over multiple years. In fact, since the 1970s, a dozen states have repealed their CON laws. There has not exactly been a surge of impassioned grassroots activists trying to bring these laws back. These states have struck at the heart of the logical fallacy on which CON laws rely: bureaucrats and regulators know what’s best for healthcare better than doctors, medical experts, and entrepreneurs.

While CON laws were originally created with the best of intentions, they have only succeeded in making healthcare more costly. By allowing hospitals and other healthcare providers to expand their services without certificates of need, they will expand access to health care for all people. Imagine if a restaurant owner needed a certificate of need to put in a few extra chairs!


Telehealth Expansion Could Help Too

Rural Mountaineers should be jumping for joy. Think of it: no longer would those living in rural areas have to travel hours for specialist care. This would be even more true with the additional expansion of telehealth access that is also gaining popularity as a non-partisan issue. The marriage of expanded telehealth and hospital services could make us all healthier and happier.

Everyone knows the state of healthcare in rural areas is not good and these developments amount to real steps toward improving healthcare quality and access for everyone – not just those living in cities like Morgantown and Charleston.


CON Laws Hurt Small, Local Providers

The state doesn’t just want to keep new competition out of the system. They went so far as to shut down a health care provider solely for not having a certificate of need proving that their services were needed. A local health source of nearly 30 years closed in an instant; all because they hadn’t filled out the required bureaucratic paper work to “prove” there was demand for their services.

In a state that has massive healthcare shortages, keeping CON laws is the wrong move to make.

Kudos to the people who have fought the long fight. Kudos to the Mountaineers who will hopefully have more accessible health care soon. By taking this courageous, long-awaited step, the state will be much better prepared for the next COVID or opiate crisis. After two generations, the CON is up.


Bradley Foster is the Community Outreach Associate for the Cardinal Institute for West Virginia Policy and a resident of Charleston, WV. 



Learn More about CON Laws

You can watch a short video about CON laws in West Virginia to better understand their impact and how reforms could help provide better health care to Mountaineers on our YouTube channel.

You can also read more about this topic from other members of the Cardinal Institute team on our blog.