Del. Scot Heckert, R-Wood, asks questions during public testimony on House Bill 2007 on Feb. 20. The bill, as it was proposed, would have eliminated certificate of need laws in West Virginia. (Perry Bennett | West Virginia Legislative Photography)
Despite a defeat in the House Committee on Health and Human Resources this week, Gov. Patrick Morrisey remains hopeful that some sort of repeal for Certificate of Need will be adopted by lawmakers this legislative session.
In a news briefing Friday, Morrisey said that he expects to see “a lot more activity” on the policy in coming days. While the end product may not be “perfect” or exactly what the governor wants, Morrisey said there are still “really good policies” that are being looked at.
A bill in the Senate that would repeal CON is still moving through the Legislature and could be brought up for consideration by the Senate Health Committee at any time.
“People declare things dead very early when things are not dead,” Morrisey said in response to a question from Ogden Newspapers’ Steven Allen Adams. “… It’s the nature of the process, right? That you have things that maybe you ask for and you get 90% of it. Let’s not confuse perfect with really good. And so we’re looking at really good policies. It may not be everything that is perfect, but we’re going to make meaningful progress.”
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 address, Morrisey called the process “big government activism at its worst” and promised that by repealing it, the state would “move toward the free market.”
It’s unclear, however, how much support exists among lawmakers on the policy push for CON repeal.
Morrisey said Friday that he believes “a majority” of Republicans — who hold supermajorities in both the House and the Senate — support policies that he says will lower health care costs and improve free market competition for health services in the state.
“We’re in a position to make good changes that put our citizens first and make sure that competition occurs and that we have lower prices and we don’t have what we have now: higher prices and the worst health care outcomes,” Morrisey said. “We should all be focusing on those terrible healthcare outcomes to make progress, because it sickens me to be 50 and we are going to move.”
There is no West Virginia-specific data showing that repealing CON in the state — where the population is declining and where 75% of people are government payers, meaning they are insured through Medicare, Medicaid or the Public Employees Insurance Agency — would accomplish such goals.
And the total elimination of CON has, historically, been a hard sell to West Virginia legislators.
The bill has been introduced annually in the House since 2017. The 2022 regular session was the first time it made it to a committee agenda. That year, after a grueling five hour debate and discussion, lawmakers on the House Health Committee voted it down 12-10.
Monday was the second time in nine years that the bill made it to committee and the second time it was voted down, as the current members of the House Health Committee voted 13-12 against House Bill 2007. Later in that meeting, the body doubled down on that vote by voting against a motion to reconsider the initial vote on the bill. Procedurally, that refusal means that specific bill will not be able to be brought up again in that committee.
“Obviously, the house has one set of issues. And we respect that people have different opinions, but I do believe that we need competition, and we’re going to be advancing it through different means,” Morrisey said.
He did not specify what “different means” entailed, though later in his comments Morrisey said that there were “tools available” to the executive branch that could be used to help drive health care competition in the state.
There were murmurs after the defeat in committee that House Republican leadership was going to attempt to discharge the bill, bringing it straight to a floor vote and sidestepping the committee process. A motion to do such, however, has yet to happen.
And other rumors circulated in the rotunda this week, as well, regarding how Morrisey and members of his staff were handling the cacophony of “no” votes in House Health against his efforts to repeal CON.
Del. Scot Heckert, R-Wood, said on the Charleston Gazette-Mail’s Outside the Echo Chamber podcast on Wednesday that Morrisey and those working for him were trying to “force” votes in favor of CON repeal this week. Heckert, a member of the House Health Committee, voted against HB 2007 and has been a vocal critic of repeal efforts.
“[Completely repealing CON] is one of the governor’s priority bills, but the governor is trying to, for lack of better words, force people to vote his way just because it’s his way and sending people around, pulling people out of committees to talk to them, to try to get them to switch their vote — we’ve gotten off to a bad start,” Heckert said. “Now hopefully we’ve learned from this lesson. Hopefully something can be done, but who knows. When you start telling people what to do ‘or else’ – especially West Virginia people – that doesn’t go very well.”
Heckert’s allegations were echoed by other lawmakers who also sit on House Health after Monday’s meeting.
Morrisey on Friday denied those claims, saying he was not going to “get distracted” by people who don’t support policies he believes will improve the state. He called such people “outliers” who “don’t speak for their districts” or who are “opposed to President Trump.”
“They’re not part of the team. I get that, so I’m not going to worry about that,” Morrisey said. “We’re going to advance an agenda, and we’re going to do it working with the vast majority of the Legislature that supports good changes.”