Certificate of Need repeal heads to governor’s desk

Lawmakers this week passed a historic bill that largely repeals South Carolina’s Certificate of Need program – a key policy priority on SCPC’s 2023-24 Legislative Agenda and a huge win for medical freedom.  

The House amended and unanimously passed the bill Tuesday. The following day, the Senate agreed to the version and gave it unanimous approval, sending it to Gov. McMaster’s desk, who is expected to sign it imminently.  

The Policy Council monitored and advocated for the proposal throughout the session, providing key updates on its progress via our weekly Statehouse Update. Last year, our polling revealed that significantly more voters support CON repeal than oppose it. The same poll found that voters strongly support expanding healthcare options in general.  

The bill as passed will eliminate Certificate of Need requirements for most healthcare providers, with a few exceptions. Building a hospital will still require CON approval through 2026, unless its located in one of the eight counties that currently don’t have one. Additionally, nursing homes and the acquisition of hospitals by the Medical University of South Carolina will still be subject to CON.

CON requires healthcare providers to go through an extensive approval process before constructing or expanding their facilities or purchasing certain equipment. In South Carolina, competing providers can challenge the requests, often resulting in much-needed healthcare facilities being held up for years. 

CON laws were ostensibly created to reduce healthcare costs and to keep too many hospitals from developing in the same place. However, research shows that CON has been disastrous for patients. A key Mercatus Center study found that CON laws are associated with higher spending and less access to rural hospitals. It also found that various mortality rates are higher in states with CON regulations. 

Getting this bill across the finish line in the final weeks of session is a huge accomplishment, one that will significantly improve healthcare access across the state. The Policy Council will continue fighting for similar reforms that increase choice and competition.