West Virginia Isn’t Family Friendly

Is West Virginia Really Committed to Being Family-Friendly?

Since 2016, the Mountain State has prided itself on its commitment to families. Through monumental education reform, parents and their children now have a say in their futures, creating brighter possibilities than ever before seen in West Virginia. Yet, despite monumental efforts to put families first, there’s work left to be done to ensure West Virginians can safely start their families here.


In a recent report from WalletHub, research found that West Virginia is one of the worst states to have a baby, ranking 45th nationally.


More specifically, “Almost Heaven” ranks:

  • 41st in healthcare overall
  • 45th in family friendliness (scores family fun, health & safety, education, child-care, affordability, and socio-economics)
  • 47th in pediatrician and family medicine physicians per capita
  • 49th in childcare centers per capita
  • 50th in infant mortality
  • 51st in baby friendliness (scores parental leave policy, mom groups per capita, child-care centers per capita, nationally accredited child-care centers, birth rate, and Medicaid-covered parenting programs policy)


Certificate of Need Laws Hurt Families

Yet, the biggest culprit contributing to poor quality of health care is too all familiar for the folks of West Virginia: Certificate of Need. 


Certificate of Need (CON) laws are regulatory barriers that require health care providers to receive authorization from a state’s health regulatory board to open a new or expand an existing facility. Thirty-five states have CON laws. 


A CON is unlike familiar regulatory processes. Some health care regulations ensure facilities meet quality standards for care and safety. CON programs determine a necessity for services based upon the anticipated investments of a prospective provider and possible commercial impact on existing regional providers. The health care markets in states with CON have made decisions contingent on state bureaucrats who have the authority to consent to or deny service, making investments costly and risky.


In West Virginia, CON regulates the following services related to birth:

  • Neonatal intensive care
  • New hospitals
  • Obstetrics services
  • Birthing centers


In a case from Virginia, an infant tragically died because a hospital failed to have the equipment necessary to save the child’s life. Virginia also has CON laws that intensely regulate necessary medical care. The Virginia government refused to let the same hospital obtain high-tech neonatal care facilities when it declared the equipment unnecessary. Due to bureaucratic control and the involvement of a market competitor, a life was lost. 


Families Should Have Access to Quality Health Care

For mothers seeking alternative medicine, the struggle for adequate care in CON states continues. Birthing centers provide high-quality care and expectant mothers sometimes prefer them to hospitals. West Virginia law requires birthing centers to have a CON. For this reason, there are only two in all of West Virginia, gravely limiting options for new families.


The evidence is clear that CON is standing between families and quality care. It’s essential to repeal CON for the sake of our families.



Jessica Dobrinsky is a Policy Analyst for the Cardinal Institute for West Virginia Policy.