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West Virginia is the only state in the nation that is completely in rugged, mountainous terrain, and our sparse population creates unique health care challenges. Our rural hospitals operate on razor-thin margins with one of the lowest cost per inpatient day in the nation, so every health care dollar matters. The CON law ensures these facilities remain viable by preventing unnecessary duplication of services that would drain limited resources from the local community.

Consider what happens without CON: Large out-of-state health care corporations cherry-pick profitable services that cater to the small percentage of West Virginians with commercial insurance. These out-of-state corporations siphon off resources that our community hospitals use to provide needed services like 24/7 emergency room coverage, diabetes education, and cancer care.

According to the Rural Health Research Gateway, from 2005 through 2022, 186 hospitals have closed, and most have been located in small rural areas, followed by large rural areas. Hospital closures are devastating to a community.

Not only does the rural community lose needed medical services, forcing 911 teams to travel further for emergency care. These communities lose jobs and a critical pillar of their community. In fact, a hospital closure is often the death knell for a community because who wants to live in a community without good access to care?

West Virginia is a rural community, but over the past five years we have been able to avoid the devastating impacts of hospital closures. In fact, West Virginia has seen several new hospitals open and other existing community hospitals expand services. These expanded services are the result of the hospital responding to community needs, often partnering with others to make the most use of the limited health care work force we have in our state. While critics point to CON as a limiting factor for expanding health care services, the reality is a national shortage of health care professionals. In fact, reports note a national shortage of 100,000 physicians, and our ability to recruit providers to our rural state is the major hurdle to access, not the CON program.

It is also important to note that elimination of the CON program could have unanticipated consequences. Today a physician can open a practice anywhere in the state and begin providing care to their community, including diagnostic imaging and laboratory services to their patients. However, if we eliminate the current CON program and move to a completely free-market model, programs such as opioid treatment centers could also open anywhere in the state. Over the years the state has worked tirelessly to ensure these services are appropriately regulated to ensure they are not next to our parks and schools.

òòò½ÊÓƵ we work to expand economic opportunities in West Virginia through the Backyard Brawl, letòòò½ÊÓƵ™s ensure we are thoughtful in our actions. We do not want to create an unlevel playing field through the elimination of the certificate of need program, allowing these large health care corporations to ship limited West Virginia dollars out-of-state.