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South Carolina ‘Certificate Of Need’ Repeal Advances

Bill to do away with bureaucratic red tape moving forward …

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A bill which would eliminate South Carolina’s unduly burdensome “Certificate of Need” (CON) program has cleared the S.C. Senate and is headed to the state’s House of Representatives.

The bill – S. 164 – passed by an overwhelming 30-6 margin in the GOP-controlled Senate last week, receiving ceremonial third reading on Friday. It is expected to be read across the desk for the first time on Tuesday in the S.C. House – where “Republicans” also enjoy a supermajority of seats (albeit a splintered supermajority).

What is ‘Certificate of Need?’

Administered by the S.C. Department of Health and Environmental Control (SCDHEC), this restrictive “regulatory regime” forces hospitals to seek state approval if they wish to build new facilities, open new practices or purchase certain types of new equipment. Certain competitors use this superfluous layer of bureaucratic red tape to stifle competition within the marketplace – resulting in fewer options and higher costs for patients and consumers.

“Large existing providers like it this way — CON laws let them veto any competition they don’t like,” noted Wilson Freeman of the Pacific Legal Foundation (PLF) in a recent guest column for this news outlet.

Conservative groups – led by Americans for Prosperity (AFP) – have been pushing for the repeal of this mandate.



“I am thrilled to see the Senate once again pass a full repeal of our state’s certificate of need laws,” AFP state director Candace Carroll said in a statement last week. “Without certificate of need laws, it will be easier to add additional beds for mental health or substance abuse treatment, for an OB-GYN to open an office in a county without one, or for a doctor to purchase a new MRI machine. I am hopeful that South Carolinians will soon have an easier time accessing the care they need close to home. Now we will focus our attention on ensuring the House takes action to give patients more options at affordable prices.”

According to a 2021 study from the Mercatus Center, CON repeal would raise the total number of hospitals in South Carolina from 82 to 116 – including nine new rural hospitals. Mercatus data further revealed that certificate of need laws add $200 annually to per capita health care spending in the Palmetto State.

Last year, the S.C. Senate passed a bill doing away with CON during the first month of the legislative session – but it stalled in the S.C. House of Representatives when powerful “Republican” leaders refused to allow it to the floor for a vote. One of those leaders – former S.C. speaker of the House Jay Lucas – received a high-paying executive position within the health care industry shortly after the bill was blocked.

Lucas is no longer in the House, and new speaker Murrell Smith appears more amenable to seeing CON repeal advance through his chamber.

Will this be the year a repeal finally passes the legislature? Momentum certainly seems to be building as even opponents of CON have begun questioning its efficacy.

“I worked on and litigated Certificate of Needs matters for years,” Columbia, S.C. attorney Christian Stegmaier tweeted recently. “In my pre-law public health policy days, I was very much for CON laws. However, as time has gone on, I’m convinced CON has run its course. Ending CON in South Carolina is the right way to go.”



Will Folks on phone
Will Folks (Brett Flashnick)

Will Folks is the founding editor of the news outlet you are currently reading. Prior to founding FITSNews, he served as press secretary to the governor of South Carolina. He lives in the Midlands region of the state with his wife and seven children.



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1 comment

WILLIAM BYRD, SR., P.E., C.S. February 7, 2023 at 12:02 pm

Repealing the Certificate of Need is a massive mistake. I served on the 3 Rivers Planning Commission for Richland, Lexington and the tri county zones in the 1980s. I had too numerous times block spending that was being driven by bribery and personal gains of members and local hospitals. One in particular comes to mind. The Lexington Hospital Heart Center Efforts. This I opposed, because we already had 2 major heart hospitals at Providence and Richland.

Instead, I wanted another Emergency Trauma Center, and expansions of all Emergency Centers in the area. Even today, we only have 1 Trauma Center at Richland, and people are dying every single day: due to this lack of facilities. The hospitals blocked this because they said it costs too much. Instead, they pushed for the more profitable and un-necessary heart hospital. After I left the Commission: “Nicky Haley,” pushed this heart hospital. She got a “no show job,” at Lexington Hospital and illegally campaigned in the State House to make it happen.

Today, people are still dying because we do not have another Emergency Trauma Center. Lexington Hospital Emergency Room has waiting times of 4 to 7 hours. People are suffering waiting on care in the waiting room. Don’t believe it, then go to the Lex. Emergency Center and see for yourself.

They, like several other hospitals in the area need vastly more Emergency Care Help and Facilities. It’s not a profit center for the hospitals. The Certificate of Need is the last brick in the wall stopping the rampant waste of tax dollars and the lack of necessary health care in our areas. KEEP THE CERTIFICATES OF NEED AND PUT MORE PEOPLE WITH BUSINESS AND CARE SENSE ON THESE CONTROLLING BOARDS!


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