Testimony Before the Virginia Education and Healthcare Committee, Subcommittee on Certificate of Need

Published February 2, 2022

Dear Madam Chair and members,

Thank you for the opportunity to testify on the need to address the acute hospital bed shortage in Virginia. My name is Matt Dean, and I am a senior policy fellow with the Heartland Institute.

The Covid-19 pandemic has exposed many flaws in our healthcare delivery systems. Now it is clear that certificate-of-need (CON) laws, that restrict the supply of hospital beds and technologies by requiring regulatory approval, have made things worse for states scrambling to alleviate the stress on overwhelmed hospitals. Restricting hospital beds and resources, and placing them into fewer and larger facilities, has made our care delivery less resilient and more susceptible to the spread of the coronavirus. Legislatures are now planning for the permanent reform of their CON laws, as temporary executive order repeals expire.

Virginia is no exception. SB205 addresses a part of this problem with a practical solution. The bed shortage, particularly in the area of psychiatric care, must be addressed with a multi-prong approach. The mental health crisis in Virginia and across the country must be met with a faster response to need in the rollout of new beds and the staffing required to care for patients. The expedited process that will result if this bill is passed will

Not long after CON laws were instituted, legislators began to wonder whether the bureaucracies created to control the supply of care were making healthcare harder to find and more expensive to buy.
For the past twenty years, that skepticism has progressively turned into legislation to reform, unwind and repeal certificate of need laws. Studies have consistently shown that states with certificate of need laws have more expensive healthcare that is less available for people in rural areas. The CON legislation was causing the disparities it was supposed to prevent.

This realization led to an uncommon bipartisan reform in healthcare policy. The Obama and Trump administrations both promoted reforms aimed at reforming certificate of need legislation.

As the coronavirus took hold in early 2019, hospital beds quickly filled, and the top priority of every governor became finding more beds and ventilators to handle the coming wave of critically ill patients. Limiting hospital beds had already been viewed by many as a weird relic of the 1970s, but the pandemic made getting rid of bed restrictions an easy decision for governors looking to respond to the coming surge of critically ill people. 20 states quickly set aside certificate of need laws and more followed.

As the pandemic enters its third year, hospitals are again overwhelmed with coronavirus variants and seasonal illness. States abandoning 1970s moratoria are looking for ways to create less concentrated care delivery models that focus on the best interests of the patient. Expediting the certificate of need process will help get Virginians the care they need faster and will save lives. 


Nothing in this testimony is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute. For further information on this and other topics, The Heartland Institute’s website provides a great link to many policy resources.

The Heartland Institute can send an expert to your state to testify or brief your caucus; host an event in your state, or send you further information on a topic. Please don’t hesitate to contact us if we can be of assistance! If you have any questions or comments, contact Heartland’s government relations department, at [email protected] or 312/377-4000.