The end of the COVID-19 public health emergency last month marked the end of several government waivers that helped expand access to care during the pandemic.
Many of those waivers deserve to be made permanent. Paramount among them is the suspension of “certificate-of-need” laws that require health care providers to obtain permission from state officials before expanding facilities or building new ones.
Certificates of need emerged at the state level in the 1960s as part of a misguided attempt to control health care spending. States most often use them to regulate the construction or expansion of long-term care facilities, outpatient facilities, and hospitals. They require health care providers to demonstrate that a community “needs” the new or expanded facilities they propose to build.
But “need” in the political world is subjective. A request for a certificate of need unleashes a wave of lobbying from incumbent providers to stop the entry of competitors. Every day that incumbents delay competition is an extra day of higher prices, less choice, and lower-quality care for patients.