Dear Madam Chairwoman and members,
Thank you for the opportunity to address the committee on the need to improve Virginians’ access to skilled care beds in our care system. My name is Matt Dean and I am a senior policy fellow with the Heartland Institute. Heartland is a 37-year old independent, national nonprofit whose mission is to develop and promote free market solutions to social and economic problems. I would like to address the policy implications of Certificate of Need restrictions in general as background for your discussion today.
Virginia has suffered with the rest of the country through the devastating COVID-19 pandemic. The loss of life, the cripplingly unfair impact on communities of color, and the elderly have made the health effects of this pandemic unprecedently insidious.
Virginia can reform antiquated Certificate of Need Laws to allow local communities to meet the bed shortage where they live. SB130 addresses one of the fundamental long-term impacts of the pandemic, a shortage of skilled care beds in our care system.
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 in many cases 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.
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.
Virginia can remove a critical barrier to care. Thank you for your service to your constituents and to your state and thank you for your efforts to improve access to care within this very important subcommittee.
For more information about the Heartland Institute’s work, please visit our website at www.heartland.org or contact the Government Relations Dept at 312-377-4000 or reach by email at [email protected]