By Stephen Smoot
Repealing Certificate of Need laws will improve access to care for some of our most vulnerable citizens and provide services that barely exist in some parts of our state,” said Governor Patrick Morrisey in a recent social media post.
He went on to add that “New health care facilities in West Virginia should not be required to request a permission slip from the government to set up services. That’s big government activism at its worst.”
While legislation introduced by Senate President Randy Smith failed to advance, the question over certificate of need laws will likely continue to arise.
The West Virginia Hospital Association succeeded in marshaling initial opposition to the bill in this session, but often reforms gain momentum from one session to the next.
In other words, the defeat of the bill was likely the start, not the end, of debates on the issue
Simply put, in general, certificate of need laws require the approval of a State or a health management authority before the establishment of a new health care facility.
Certificate of Need laws emerged first in the Great Depression in the transportation industry. About three decades later, in 1964, New York State passed the first one in reference to health care entities. By 1974, the National Health Planning and Resources Development Act. The bill cited as justification that “massive infusion of Federal funds into the existing health care system [that] has contributed to inflationary increases in the cost of health care and failed to produce an adequate supply or distribution of health resources, and consequently has not made possible equal access for everyone to such resources.”
According to Jim Kaufman, repealing certificate of need laws will invite health care companies to “enter West Virginia and cherry pick by developing only profitable lines of service at the expense of rural health care in West Virginia.”
He added the speculation that these same companies would establish “feeder facilities” that would channel West Virginia patients to out of state providers. He said “these dollars should remain in West Virginia and flow back into health programs and services for West Virginians.”
Jessica Dobrinsky, executive director of the Mountain State-based Cardinal Institute, agrees with Governor Morrisey on the negative impact of certificate of need.
First, she stated that the expected benefits of the laws never materialized. Starting with President Ronald Reagan, Dobrinsky explained, every president, including those as opposite as Barrack Obama and Donald Trump, have suggested that states would improve health care by eliminating certificate of need laws.
She added that West Virginians end up going across state lines already to seek care often not as available in state in counties near state boundaries.
Another difficulty that has arisen in recent years is the decline in the availability of pediatric care in parts of West Virginia. Parents in many areas, including State Senator Patricia Rucker of Jefferson County, have had to seek care outside the state.
The rationale behind ending certificate of need laws lies in the notion that more access, more opportunities, and more organic growth will improve health care quality overall.
Dobrinsky cited the example of a health care facility in Mineral County that served approximately 30 patients per day and served the Short Gap community for almost three decades. Hunt Club, operated by Western Maryland Health, seemed to serve a need in the market, but lacked the official certificate of need to operate.
Even worse, Dobrinsky shared, the certificate of need keeps needed facilities from being built in the first place.
“One great thing about the certificate of need issue,” she went on to say “is that all the data is on the side of repeal.”
Indeed, many states have dropped the statutes and none have recently added them. Twelve states that had passed them eliminated them by Jan 1, 2024.
