West Virginia’s Certificate of Need Law is A Barrier to Better Healthcare

In West Virginia, Governor Patrick Morrisey is leading the charge to repeal the state’s antiquated Certificate of Need law, a bureaucratic relic that stifles competition, increases costs, and limits access to care for West Virginians.

SB 453, introduced by Senate President Randy Smith and Senate Minority Leader Mike Woelfel, would repeal the Certificate of Need process, and provide a much-needed step toward patient-centered reform. Governor Morrisey was quoted on the need for certificate of need reform by saying, “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,” he said in a recent social media post. “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.”

Certificate of need laws require healthcare providers to obtain government approval before expanding services, opening new facilities, or purchasing major medical equipment. Originally implemented to control costs, these laws have had the opposite effect, creating artificial scarcity, driving up prices, and giving established medical providers a monopoly over healthcare services.

Certificate of need laws restrict competition and drive-up costs by requiring state approval before new hospitals, surgical centers, or imaging facilities can open. This process allows existing healthcare providers to block competition by preventing new entrants into the market from offering lower prices and better services to patients.

Studies show that states without Certificate of need laws have lower healthcare costs and increased access to services. This is of particular concern in rural states like West Virginia, which experience some of the worst healthcare outcomes of the 50 states. Yet, the current certificate of need process limits new providers from setting up healthcare facilities where they are needed most, forcing patients to travel long distances for care, particularly for specialty services.

Certificate of need laws hurt patients, not just businesses, since an inefficient government panel, not market demand, decides whether a new hospital or clinic can open. This centralized planning model fails patients, especially in fast-growing areas or underserved rural regions. Data shows that states without certificate of need laws have more hospital beds, more imaging services, and shorter wait times.

While proponents of certificate of need say that these laws are necessary, it should be noted that twelve states have no such laws on the book, and many states are reducing or completely removing certificate of need laws from their books. A notable example would be New Hampshire, which recently repealed these laws to boost hospital bed capacity, proving that these laws styme efficient healthcare and should be repealed.

Repealing the certificate of need process is a free-market-oriented healthcare reform that would expand access, lower costs, and improve patient outcomes. West Virginia lawmakers should pass SB 453 and empower patients, not bureaucrats, to determine healthcare needs.