‘CON’ laws hindering access to better Hawaii healthcare

from Grassroot Institute of Hawaii, November 5, 2023

Hawaii’s red tape affects virtually every facet of life in the islands, including the delivery of life-saving medical care.

Speaking with H. Hawaii Media radio host Johnny Miro on Sunday, Malia Hill, policy director for the Grassroot Institute of Hawaii, provided an in-depth look at medical certificate-of-need laws and presented a compelling case for their repeal or reform.

CON laws require anyone seeking to offer new healthcare services in Hawaii to file an application with the state and essentially prove the proposed services are needed. Hill noted that Hawaii has the most restrictive CON laws in the U.S., applicable to 28 different services ranging from the construction of new healthcare facilities to simply adding hospital beds. 

CON law supporters argue that healthcare should be exempt from competition, asserting that these laws are necessary to control costs by preventing duplication of services. 

But Hill said more than 400 different studies have shown that CON laws tend to lower healthcare access and increase costs to patients.

She referenced a Mercatus Center study that estimated repealing CON laws in Hawaii could result in “11 more hospitals, including four more rural hospitals [and] two more ambulatory surgical centers.”

In addition, she said “per capita healthcare spending would be reduced by about $219 a year, post-surgery complications would go down [and] fewer people would have to travel for out-of-county imaging scans.” 

Hill said a complete repeal of CON laws would be ideal, but other options could include increasing the monetary threshold for CON applications, exempting certain critical services from needing a CON, prohibiting competitors from intervening in the CON decision-making process, and eliminating “duplication” as a valid reason for denying CON applications.

---30---

Mercatus: Hawaii-and-certificate of need-programs