Natural State News

Arkansas is one of 36 states that currently limit entry or expansion of health-care facilities through certificate-of-need (CON) programs, according to media reports.

CON programs prohibit health-care providers from entering new markets or making changes to their existing capacity without first gaining approval from state regulators, said Arkansas state Rep. Jack Ladyman (R-Jonesboro), who chairs the Arkansas House Public Health, Welfare and Labor Committee.

“I will be discussing CON with members of the Public Health, Labor and Welfare Committee to judge the amount of interest in running legislation for this purpose,” Ladyman told Natural State News. “Only a few members have mentioned this to me so I'm not sure there is enough interest to pass legislation. More time is needed to test the waters on this issue.”

Arkansas is one of only 15 states that maintained CON regulations during the COVID-19 crisis, according to Pacific Legal data.

“We are a rural state and are struggling to improve health care in our rural areas,” Ladyman said. “We would not want to do anything that reduces access or quality of care in rural areas. However, competition does improve quality and cost, so I will be looking into eliminating CON.”

Arkansas passed its certificate-of-need laws in 1975. The measures cover six devices and services, including nursing home beds and long-term-care beds, psychiatric services and assisted-living and residential-care facilities, according to media reports.

“Our legislature has a supermajority of conservative Republicans who support free markets and competition in the health-care industry," Ladyman said. “However, our medical professionals vigorously protect the quality of health care. I don't know if there will be support for the elimination of the CON. I do know that after vigorous debate our committee will make the decision that best serves the people of Arkansas.”

As previously reported, Americans for Prosperity analyst Candace Carroll highlighted the problems posed by certificate-of-need laws during the COVID-19 pandemic.

“For hospitals to be able to increase that capacity rapidly without having to go through this archaic system of getting a permission slip from the government and competitors allowed them to care for more patients," Carroll said.

A recent study conducted by Thomas Stratmann and Jacob Russ of George Washington University found no relationship between CON programs and increased access to health care for the poor. The study further revealed that Arkansas’ CON programs have resulted in 2,937 fewer hospital beds, between six and 12 fewer hospitals offering magnetic resonance imaging (MRI) services, and between 15 and 21 fewer hospitals offering computed tomography (CT) scans.

“We have three doctors, one nurse, one hospital administrator and other individuals that work in the medical industry, so a discussion will be lively and complete,” Ladyman said. “I expect some concern about reducing access and increasing cost for medical care in rural areas. I expect those who work in metropolitan areas or large hospitals to promote the improvements with the elimination of CON.”

Strict enforcement of CON programs, however, can cause health-care costs to rise by as much as 5%.

“Many states temporarily suspended certificate-of-need laws during the pandemic, and now they are wondering how it affected access to health care for our most vulnerable populations and if some of these changes should be considered long-term,” Alicia Plemmons, co-founder of the Scope of Practice and Medical Licensure Research Group at the University of Central Arkansas, told Advantage News.