In North Carolina, 25 types of medical services are rationed by the state's certificate of need law. No healthcare organization — other than a federal medical provider — is permitted to provide the listed medical services without first obtaining a CON from the state's department of Health and Human Services. However, a bill to repeal the CON laws is pending in the state Senate, according to the Fay Observer.
It is unclear whether the bill will advance before the legislature's adjournment, which is expected to occur in the next several weeks, according to the report.
Those who seek to eliminate the CON laws argue they suppress free-market competition, restrict services and create higher healthcare costs.
"Powerful stakeholders like the North Carolina Hospital Association have successfully blocked many legislative reform initiatives, since nonprofit health systems generally leverage CON to their advantage," Karen Restrepo, an analyst with the free-market John Locke Foundation wrote in a 2015 report on the issue, according to the Fay Observer. "After all, what law better protects their fortresses from potential competitors who could possibly provide more innovative services at a fraction of the cost?"
Advocates of the laws say they are critical for protecting organizations in areas with large populations of poor patients who cannot afford to pay medical bills and lack sufficient coverage, according to the report.