Improve Health Care Competition by Repealing State Laws

NCPA, January 23, 2015

While the Affordable Care Act has introduced a host of new mandates on individuals, employers and insurers, there are a few things that states can do to improve the health care market within their borders. In a new report from the Mercatus Center, Matthew Mitchell, Anna Mills and Dana Williams offer three reforms that would improve competition and patient choice: 

• Repeal certificate of need (CON) laws. Thirty-five states (including Hawaii) have these laws, which limit people's ability to open new health care facilities or expand offered services unless they can prove to the state that the community needs the service. These regulations limit competition and result in hospitals with fewer beds, fewer services and less equipment.
• Liberalize scope-of-practice regulations. These laws determine what services non-physician health care providers, such as nurse practitioners, can undertake while caring for patients. These regulations raise prices for consumers without improving patient care.
• Remove barriers to telemedicine. Telemedicine (or telehealth) is the use of technology to diagnose and treat patients remotely. While telemedicine can improve access and efficiency, state laws limit their use; for example, 41 states prevent doctors from writing prescriptions without first conducting in-person exams. This is something that NCPA Senior Fellow Devon Herrick has written about, explaining that telemedicine could break down barriers to care.

While lawmakers continue to debate the federal government's role in the health care market, states could take these steps to improve conditions within their borders.

Source: Matthew Mitchell, Anna Mills, and Dana Williams, "Three Prescriptions for States to Improve Health Care," Mercatus Center, January 2015.