Certificate of Need laws are standing in the way of addiction recovery

By Starla Brown
February 7, 2023

Mississippi legislators missed the opportunity to repeal the CON laws and prevent the dangers they cause for Mississippians.

By any measure, America is experiencing a substance use crisis. In 2021, deaths from overdoses reached an estimated 107,622 people across the United States, with roughly another 140,000 deaths due to excessive alcohol use. Unfortunately, Mississippi has not been spared from this epidemic. In 2021 alone, 491 people died from opioid overdoses, and over 2,500 people required Narcan to be revived after an overdose.

Numerous factors contribute to a person’s substance abuse, and it can be very difficult for them to realize or be convinced by their loved ones that they need professional help to get sober and get their life back on track. However, as the substance use crisis continues to get worse, facilities that provide treatment are hamstrung by antiquated regulations that prevent them from scaling up their ability to care for patients in need.

In nearly every industry or sector of the economy, when there is an increased demand for a business’s goods or services the relevant companies will simply scale, either by expanding their current operations or building new locations altogether. However, thanks to Mississippi’s Certificate of Need laws, the health care industry is prevented from scaling up as needed.

And when that happens, it’s patients — the very people these laws were supposed to help — who suffer.

Our state’s CON law requires that facilities that provide rehabilitation care must receive regulatory permission to expand or establish new locations or even just to add additional beds at inpatient facilities. This process takes months and can cost up to $25,000.

Additionally, this process includes a provision to allow “affected persons” to request a public hearing to argue against granting the Certificate of Need. “Affected persons” includes health care organizations that already provide a similar service or have indicated to the state that it plans to offer similar services in the future.

This provision is ostensibly to ensure that there is adequate care and to keep medical costs down, but, in reality, it provides a way for competing health care providers to try and limit their competition. We would think it odd if Mcdonald's had to secure permission from Burger King to open a new location, yet for some reason this is considered a good idea when it comes to health care.

The data is overwhelmingly clear that despite whatever good intentions lie behind these CON laws, they simply serve to reduce access to care and make it more expensive. A study by the University of Washington’s School of Public Health and Community Medicine compared and contrasted results in states with and without CON laws and found that they are “not an effective mechanism for controlling overall health care spending” and that they had in some cases actually limited the supply of care. Before their total repeal in Pennsylvania, CON laws had limited the supply of alcohol and chemical dependency beds.

Recent reports have confirmed these results. A multitude of research has found that states with CON laws have higher costs and less access to treatment, beds, and medical equipment.

Substance use is a crisis, and there is no time to waste in months of bureaucratic paper shuffling to improve access to treatment.

Unfortunately, Mississippi legislators missed the opportunity to repeal the CON laws that are preventing Mississippians who are struggling with substance use from being able to access the care that they need. House Bill 10 was introduced at the beginning of this legislative session and would have amended the relevant laws to remove chemical dependency services and facilities from CON regulations. It failed in committee by vote last week.

Passing House Bill 10 would have ensured more access to care, lower prices, and shorter wait times for people struggling with substance use by allowing Mississippi health care facilities to expand their ability to treat them without months of bureaucratic hoop-jumping that in the end only leads to higher costs and worse health outcomes.

This bill would have been a win-win-win that would have saved health care providers months of bureaucratic headache, allowed people with a substance abuse problem to access quality care at lower prices, and saved taxpayers money by reducing the negative consequences that stem from untreated substance abuse.

Americans for Prosperity Mississippi will continue to educate the public about the dangers of Certificate of Need laws and encourage legislators to pass H.B. 10 next year to ensure that Mississippians in crisis can access the care they need.

Submitted by Starla Brown. She is the State Director of Americans for Prosperityan allied organization of the Mississippi Center for Public Policy.

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