Below is a political opinion column by Starla Brown and Thomas Kimbrell:
The implication is clear: exempting facilities and services from CON restrictions will expand access to them.
On January 28, a federal district court struck down Mississippi’s long-standing moratorium on the establishment of certain new health care facilities, calling the forty-year application of the moratorium “irrational.”
On the same day, the Mississippi Legislature passed a bill easing other long-standing restrictions on new health care. If signed into law, the bill will allow health care providers to purchase medical equipment and establish facilities without first obtaining a government permission slip if the capital expenditure is below a certain threshold.
The court ruling and the newly passed bill both amend Mississippi’s certificate of need (CON) law. The CON law requires health care providers to obtain approval from the state before establishing or expanding health care facilities, services, or equipment. Providers must prove to the state that their services are needed before offering them.
Mississippi has one of the nation’s most extensive and restrictive CON laws, which serves as an unnecessary barrier between patients and providers. The CON program pits providers against each other to fight for government favor, diverting resources from patient care. Rather than appeal to patients, providers must petition the government’s central planners for permission to care.
The Mississippi Legislature adopted the CON law in 1979, believing that it would increase access to and quality of care while “avoiding unnecessary costs.” However, decades of research have shown the opposite. Compared to states without CON laws, states with CON are associated with higher health care spending, fewer medical facilities, and inferior patient outcomes.
A recent study finds that Mississippians could expect to spend $400 less per person per year on health care if CON is repealed. The study also finds a significant reduction in annual Medicaid and Medicare spending in other states after CON repeal.
In a 2024 report, the Mississippi State Department of Health (MSDH) — the agency that administers the CON program — recommended considering CON exemptions for services where Mississippi significantly lags the rest of the nation, including psychiatric care and substance use disorder facilities as well asmaternal and infant care services.
The implication is clear: exempting facilities and services from CON restrictions will expand access to them.
It should be obvious to any Mississippian that a 40-year moratorium on the establishment of new health care facilities won’t serve to increase access to health care. The Federal District Court for the Southern District of Mississippi agrees. The opinion comments on the “absurdity” of the state maintaining the moratorium — which is part of the CON law — for over forty years and ruled it unconstitutional.
That same day, just three weeks into the legislative session, the Senate passed HB 3 to reform the CON law. The bill is currently pending Governor Reeves’ signature to become law.
Most significantly, the bill would raise the dollar amount thresholds for capital expenditures that trigger the CON requirement. That is, if the cost of establishing or expanding a medical facility, or purchasing medical equipment, exceeds a certain dollar amount, a CON is required to do so. This bill would raise that threshold, freeing providers to expand some services and purchase less expensive equipment.
While the court struck down the decades-old moratorium on new health care facilities, the decision leaves intact the broader CON structure. The ruling makes it clear that the Mississippi Legislature must act to modernize Mississippi’s outdated CON system. HB 3 is a great start.
Mississippi ranks last in health care access and quality and 44th in affordability. There is plenty of time left in this legislative session, and lawmakers have expressed interest in adopting further reforms to the CON law.
Removing additional restrictions or repealing CON altogether would be a huge step toward expanding patient choice, increasing affordability, and improving health care in the Magnolia State.
Starla Brown
Starla Brown is State Director of Americans for Prosperity-Mississippi.
Thomas Kimbrell
Thomas Kimbrell is a policy analyst with Americans for Prosperity.
-- Article credit to Starla Brown and Thomas Kimbrell for the Magnolia Tribune --
