Del. Mike Pushkin, D-Kanawha, urges the House Health Committee to vote down House Bill 2007 during debate on Monday. Pushkin was the only legislator to speak on the bill during Monday’s meeting. (Perry Bennett | West Virginia Legislative Photography)
Lawmakers on the West Virginia House Health Committee on Monday voted down a committee substitute for a bill that would have, as it was proposed, repealed the Certificate of Need process statewide.
The policy push to repeal Certificate of Need, or CON, was announced by Gov. Patrick Morrisey as a priority for his administration during his State of the State address earlier this month. On Monday, members of the House Health Committee voted 13-12 against House Bill 2007, dealing a major blow to that priority.
A bill in the Senate that would repeal CON is still moving through the Legislature, however, and could be brought up for consideration by the Senate Health Committee at any time.
Monday was at least the second time that the House Health Committee has quashed efforts to totally repeal CON in the state. In 2022, with three members absent and not voting, the body voted 12-10 against a similar bill that would have done away with the process completely.
CON is a regulatory process, overseen by the West Virginia Health Care Authority, that requires entities looking to create or expand health care services in the state to receive a legal document proving those new services fit an unmet need in the area.
Through the Health Care Authority, those interested in obtaining a Certificate of Need receive technical assistance before applying to see what need they are meeting. Services are approved through a needs methodology and different services — such as hospice care, ambulatory centers, clinics, private practices and specialty services — have different methodologies.
During his State of the State, Morrisey called the process “big government activism at its worst” and promised that by repealing it, the state would “move toward the free market.”
Proponents for the repeal believe that doing away with the laws will allow more competition in health care across West Virginia. Those against repeal worry that doing away with the process will hurt West Virginia’s more rural and vulnerable populations, where a lack of regulation could threaten what services are offered to the 75% of residents who are government payers, meaning their health insurance comes from Medicare, Medicaid or the Public Employees Insurance Agency.
Last week, people packed into the House Health Committee meeting as 12 speakers addressed lawmakers on their beliefs regarding the total repeal of CON. While the version of the bill voted down this week was notably different than that initially proposed — and, therefore, what Thursday’s speakers testified on — it would have majorly restructured CON.
There was little discussion or debate from committee members before Monday’s vote.
The proposed committee substitute they voted down would have removed swaths of state code regarding CON while leaving in place moratoriums on the creation or expansion of certain health care services, including for methadone, nursing homes, hospice care and more.
The bill would have completely eliminated the Health Care Authority and given oversight responsibilities for hospitals to the West Virginia Attorney General, who would have been tasked with ensuring that “the conduct of the hospital or health care provider furthers the policy goals of the state.” The attorney general, per the bill code, would have monitored reimbursement rates set by hospitals, the costs of services offered, the kinds of services available in regions and more. Any increases in rates charged would have had to be approved by the attorney general.
Other oversight would have come from the cabinet secretary for the state Department of Health and, to a certain degree, the Legislature, according to comments given by counsel for the committee.
Legislative action would have been needed to allow for certain medical services, counsel said. Specifically, if a hospital was struggling or closed and another hospital system wanted to take over its services, lawmakers would have needed to pass a law allowing the takeover.
Del. Mike Pushkin, D-Kanawha, proposed an amendment to the bill on Monday that would have lifted the existing moratorium for methadone clinics. That moratorium, he said, has created a “not well regulated monopoly” for treatment providers.
Lawmakers on the committee denied Pushkin’s amendment via voice vote.
Speaking on the bill overall, Pushkin said he believed it was “flawed” and “not well thought out.”
“I think we’ve created more problems once again,” Pushkin said.
No other members of the committee offered thoughts on the bill during Monday’s meeting.
Pushkin, later in Monday night’s meeting, made a motion to reconsider the initial vote on HB 2007. Following a short recess, lawmakers voted down that motion via voice vote and the original vote of 13-12 stood against the bill.
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