Certificate of Need prevents Access to Care: South Carolina’s legislators can and must do better

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May 20th, 2016

As a nationwide senior’s organization with more than 3,000 supporters and activists in South Carolina, RetireSafe is focused on ensuring safe, reasonable access to health care at the lowest cost. For the past few years, we’ve been reviewing the efficacy of Certificate of Need (CON) laws in multiple states and have found that these antiquated laws present a significant barrier to local access to quality care. For example, in South Carolina CON laws have shown to be a roadblock that prevent hospitals and healthcare facilities from opening in counties where they are needed, while allowing other facilities the ability to block competitors from offering needed services in their market.

During the 2015 legislative session, South Carolina’s House of Representatives passed a bill to end the state’s Certificate of Need Program, starting with reducing restrictions on services over the next two years and ending the program by January 1, 2018. Unfortunately, in this year’s legislative session, the State Senate stalled the bill, with the Medical Affairs subcommittee voting to remove the sunset provision altogether.

Certificate of Need legislation is a 40-year-old restriction on healthcare services that was previously tied to federal funds. Even the federal government has acknowledged that CON is outdated and fails to facilitate competition.  Yet, in the Palmetto state, CONs are still in force with their overbearing bureaucratic red tape and onerous application reviews to determine whether there is an existing “need” for the service. The review process is a lengthy and expensive requiring medical facilities to spend thousands of dollars with no guarantee they’ll be granted the service they applied for.  Bottom line, CON laws are simply outdated laws that lead to delays in healthcare expansion, block competition and fail to control costs or improve care.

South Carolina has one of the most restrictive CON laws of any state, regulating upwards of 20 services.  The Mercatus Center has noted that South Carolina’s CON program:

“could mean approximately 6,331 fewer hospital beds, between 10 and 19 fewer hospitals offering MRI services, and between 33 and 41 fewer hospitals offering computed tomography (CT) scans.”

That means that anyone seeking healthcare in South Carolina will run into higher costs and fewer choices.

Certificate of Need laws have come under fire nationwide. Many states have considered the costs and their impediment to patient access of healthcare of these CON laws and repealed them. South Carolina’s legislators have failed to make any significant changes to their CON laws and as a result South Carolinians do not have access to the care they need. It is time for the Palmetto state to put patients first, and repeal these outdated CON laws.