{"id":2598862,"date":"2026-05-05T09:03:57","date_gmt":"2026-05-05T13:03:57","guid":{"rendered":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/health-care-would-improve-if-more-states-eliminated-hospital-permission-slips\/"},"modified":"2026-05-05T09:12:57","modified_gmt":"2026-05-05T13:12:57","slug":"health-care-would-improve-if-more-states-eliminated-hospital-permission-slips","status":"publish","type":"post","link":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/health-care-would-improve-if-more-states-eliminated-hospital-permission-slips\/","title":{"rendered":"Health Care Would Improve If States Nuked This Hospital Red Tape"},"content":{"rendered":"<aside class=\"mashsb-container mashsb-main mashsb-stretched\"><div class=\"mashsb-box\"><div class=\"mashsb-count mash-medium\" style=\"float:left\"><div class=\"counts mashsbcount\">22<\/div><span class=\"mashsb-sharetext\">SHARES<\/span><\/div><div class=\"mashsb-buttons\"><a class=\"mashicon-facebook mash-medium mash-nomargin mashsb-noshadow\" href=\"https:\/\/www.facebook.com\/sharer.php?u=https%3A%2F%2Fwww.conservativenewsdaily.net%2Fbreaking-news%2Fhealth-care-would-improve-if-more-states-eliminated-hospital-permission-slips%2F\" target=\"_top\" rel=\"nofollow\"><span class=\"icon\"><\/span><span class=\"text\">Facebook<\/span><\/a><a class=\"mashicon-twitter mash-medium mash-nomargin mashsb-noshadow\" href=\"https:\/\/twitter.com\/intent\/tweet?text=&amp;url=https:\/\/www.conservativenewsdaily.net\/breaking-news\/?p=2598862&amp;via=ConservNewsDly\" target=\"_top\" rel=\"nofollow\"><span class=\"icon\"><\/span><span class=\"text\">Twitter<\/span><\/a><a class=\"mashicon-subscribe mash-medium mash-nomargin mashsb-noshadow\" href=\"#\" target=\"_top\" rel=\"nofollow\"><span class=\"icon\"><\/span><span class=\"text\">Subscribe<\/span><\/a><div class=\"onoffswitch2 mash-medium mashsb-noshadow\" style=\"display:none\"><\/div><\/div>\n            <\/div>\n                <div style=\"clear:both\"><\/div><\/aside>\n            <!-- Share buttons by mashshare.net - Version: 4.0.47--><p>Health care in many states relies on \u201ccertificates of need\u201d (CON), a permission-slip system created in earlier planning laws. Under CON rules, states require approval before new <a href=\"https:\/\/www.conservativenewsdaily.net\/breaking-news\/no-spike-in-florida-coronavirus-cases-despite-no-mask-mandate\/\" title=\"No Spike in Florida Coronavirus Cases Despite No Mask Mandate\">health care<\/a> facilities-such as hospitals or nursing homes-or expansions can occur. As of the most recent reporting, most states (35 plus D.C.) still have some form of CON requirement.<\/p>\n<p>The article argues that CONs are based on the idea that increasing supply leads to higher spending and overuse, so regulators try to limit growth. However, it highlights research suggesting CON programs tend to <a href=\"https:\/\/www.conservativenewsdaily.net\/breaking-news\/analysis-democrats-say-theyre-taxing-the-rich-but-theyre-actually-crushing-small-businesses\/\" title=\"Analysis: Democrats Say They\u2019re \u2018Taxing The Rich,\u2019 But They\u2019re Actually Crushing Small Businesses\">raise costs<\/a>, reduce access, and worsen quality. The key criticism is that they protect existing providers (frequently enough large incumbents), limiting competition that could or else pressure prices and improve care.<\/p>\n<p>It then points to reforms-especially in Tennessee-where the state eliminated the requirement for new hospitals to obtain CON approval from a commission,with the change scheduled to take effect in July 2028. The author notes Tennessee also previously loosened CON rules for satellite emergency rooms and made it easier to open hospitals in rural areas. More broadly, the piece claims federal actions are now encouraging state deregulation by tying additional points in rural health grant applications to repealing CON laws.<\/p>\n<p>the argument is that government boards shouldn\u2019t be able to block new competitors in health care,and that CON regimes have failed to deliver affordable,accessible care-so states should scale back or repeal them entirely.  <\/p>\n<p class=\"readmore\">\n    <button onclick=\"showReadMore()\" id=\"readmorebtn\">Read more&#8230;<\/button>\n<\/p>\n<hr id=\"line\">\n<span id=\"more\"><\/p>\n<div>\n<p>Imagine having to go before a government board to obtain a permission slip to open a new business. Your would-be competitors could lobby that board and argue that the government shouldn\u2019t issue said permission slip, killing your business before it ever gets off the ground.<\/p>\n<p>As crazy as it sounds, this dynamic occurs within health care regularly. Planning laws originally created in the 1960s and 1970s stifle competition, <a href=\"https:\/\/www.conservativenewsdaily.net\/breaking-news\/big-government-locks-young-people-out-of-the-american-dream\/\" title=\"Big Government Locks Young People Out of the American Dream\">increasing health care costs<\/a> while discouraging quality innovations. Thankfully, some states are <a href=\"https:\/\/www.conservativenewsdaily.net\/breaking-news\/tech-expert-confirms-voting-machines-connected-to-internet-during-ga-senate-subcommittee-on-elections\/\" title=\"Tech expert ...firms voting machines ...nected to internet during Ga. senate subcommittee on elections\">taking action<\/a>, giving customers more choice in ways that can help to thwart hospital monopolies.<\/p>\n<h2><strong>State \u2018Certificate\u2019 Programs<\/strong><\/h2>\n<p>In health care, the permission slip concept comes via certificates of need (CON). States issue these certificates to allow the creation of new health care facilities (e.g., hospitals, nursing homes, etc.), or the expansion and growth of existing facilities.<\/p>\n<p>As of last April, 35 states and the District of Columbia had some form of certificate of need mandate in place, according to the <a href=\"https:\/\/www.ncsl.org\/health\/certificate-of-need-state-laws\" target=\"_blank\" rel=\"noreferrer noopener\">National Council of State Legislatures<\/a>. Congress had attempted to require states to enact such measures in a 1974 law, but it subsequently repealed that mandate over a decade later, in 1987.<\/p>\n<h2><strong>Big Government Approach<\/strong><\/h2>\n<p>The theory behind CONs holds that the available supply of health care correlates with spending on the same. Expanding the available hospital beds (or MRI machines or whatever) in a given area will encourage people to consume \u2014 and perhaps overconsume \u2014 additional health care. Or, to quote <em>Field of Dreams<\/em>, \u201cIf you build it, they will come.\u201d<\/p>\n<p>But individuals with a more market-based perspective would beg to differ, noting that flawed incentives within the health care system create their own economic dynamics. By making care \u201cfree\u201d or nearly so through myriad programs and generous subsidies, the government encourages additional consumption of health care, requiring yet more <a href=\"https:\/\/amzn.to\/3YuVZYV\" >heavy-handed government regulation<\/a> in the form of certificate of need programs as an arbitrary choke on supply.<\/p>\n<p>More to the point: Research has found CON programs to be ineffective at best. Literature <a href=\"https:\/\/www.mercatus.org\/system\/files\/mitchell-con-qa-mop-mercatus-v2.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">reviews<\/a> conducted by the Mercatus Center have found that these programs raise costs, limit access to care, and lead to deteriorations in quality. It isn\u2019t hard to figure out why: Certificate of need entrenches incumbents \u2014 in many cases, big hospitals \u2014 eliminating potential sources of competition that can mitigate rising costs and improve quality.<\/p>\n<h2><strong>States Taking Action<\/strong><\/h2>\n<p>Thankfully, some states are taking measures to rein in the unwieldy and counterproductive CON framework. Last month, Tennessee <a href=\"https:\/\/www.timesfreepress.com\/news\/2026\/apr\/21\/tennessee-legislature-continues-unwinding-of\/\" target=\"_blank\" rel=\"noreferrer noopener\">eliminated<\/a> the requirement that new hospitals go before a state commission to receive a certificate of need before they open. That provision, which will take effect in July 2028, passed by broad bipartisan margins of 84-11 in the state House and 28-1 in the state Senate. It came two years after Tennessee removed CON restrictions on satellite emergency rooms, while making it easier to open hospitals in rural counties without one.<\/p>\n<p>And whereas the federal government had pushed states to enact CON restrictions in the 1970s, this time Washington has helped promote state deregulation. An <a href=\"https:\/\/www.timesfreepress.com\/news\/2026\/apr\/21\/tennessee-legislature-continues-unwinding-of\/\" target=\"_blank\" rel=\"noreferrer noopener\">article<\/a> on the recent action in Tennessee noted that the \u201ceffort was boosted by a demand from President Donald Trump\u2019s administration.\u201d With states\u2019 applications for the Rural Health Transformation Grants included in last year\u2019s <a href=\"https:\/\/wordpress.juniperresearchgroup.com\/wp-content\/uploads\/2025\/08\/BBB-Summary.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">budget reconciliation bill<\/a> receiving additional points based on the repeal of their CON laws, the Trump administration is leveraging federal dollars to move state health policy in a positive direction.<\/p>\n<p>On a philosophical level, no entity should have its existence made contingent on approval from a government board. And as a practical matter, such restrictions have proven ineffective and undermined the goal of affordable, readily accessible health care. It\u2019s time for all states to follow in the steps of Tennessee and scale back their certificate of need programs. Better yet, they should repeal these statutes and end the CON games once and for all.<\/p>\n<hr>\n<div>\n<p>      Chris Jacobs is founder and CEO of Juniper Research Group and author of the book &#8220;<a href=\"https:\/\/www.amazon.com\/dp\/1645720020\">The Case Against Single Payer<\/a>.&#8221; He is on Twitter: <a href=\"http:\/\/twitter.com\/chrisjacobsHC\">@chrisjacobsHC<\/a>.<\/p>\n<\/div><\/div>\n<p><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Imagine needing approval from a government board to open a business<\/p>\n","protected":false},"author":521,"featured_media":2598865,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_mo_disable_npp":"","fifu_image_url":"https:\/\/thefederalist.com\/wp-content\/uploads\/2026\/05\/Nurse-Wheelchair-Photo.jpg","fifu_image_alt":"","footnotes":""},"categories":[546,33651],"tags":[40105,37167,79119],"class_list":["post-2598862","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-the-federalist","category-the-western-journal","tag-government-regulation","tag-healthcare-policy","tag-hospital-administration"],"fifu_image_url":"https:\/\/thefederalist.com\/wp-content\/uploads\/2026\/05\/Nurse-Wheelchair-Photo.jpg","_links":{"self":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/posts\/2598862","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/users\/521"}],"replies":[{"embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/comments?post=2598862"}],"version-history":[{"count":3,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/posts\/2598862\/revisions"}],"predecessor-version":[{"id":2598867,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/posts\/2598862\/revisions\/2598867"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/media\/2598865"}],"wp:attachment":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/media?parent=2598862"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/categories?post=2598862"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/tags?post=2598862"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}