A continuing feature: Looking at bills supported by House Republicans during the 153rd General Assembly that did not become law…but probably should have.
Abolishing the Deterrent to Building More Healthcare Capacity
In Delaware, state law requires healthcare providers to obtain government approval to purchase some types of major equipment, expand bed capacity, or open new facilities. This authorization is issued as a Certificate of Public Review (CPR), sometimes referred to as a Certificate of Need (CON), by the Delaware Health Resources Board.
House Bill 318, sponsored by State Rep. Bryan Shupe (R-Milford South, Ellendale, Lincoln), would abolish the process by eliminating the board. The bill was introduced in mid-March and assigned to the House Health & Human Development Committee where it died without a hearing.
The General Assembly did approve a related bill (House Bill 17) that repealed the requirement to obtain a Certificate of Public Review before making major medical equipment purchases below a certain cost threshold. Sponsored by House Majority Leader Kerri Evelyn Harris (D-Dover), that bill was allowed to progress, received bipartisan support, and was approved. It took effect on July 1.
While supporting that change, Rep. Shupe maintains more needs to be done. “Healthcare providers should be able to expand their operations based on their assessment of addressing patients’ needs, without being hampered by needless state bureaucracy.”
Advocates of eliminating Certificates of Public Review believe they restrict market competition, inflate healthcare costs, and create artificial shortages of medical facilities and equipment. They also argue that CPRs and other similar requirements are an outdated relic of failed federal policy.
According to the State Policy Network, the federal government passed the National Health Planning and Resources Development Act in 1974, withholding funds from states that did not enact Certificate of Need programs. By the early 1980s, every state except Louisiana had enacted a version of CON laws. They were originally put in place to control healthcare costs, increase healthcare quality, and improve access to care for low-income families. But research shows CON laws have failed to achieve their stated goals and have actually done the opposite of what they were intended to do. The federal government noticed these laws weren’t meeting their intended goals and repealed the CON mandate in 1986.
