Of the more intense debates in the House of Delegates this session, have been those surrounding the issue of health care reform with respect to Virginia’s Certificate of Public Need laws, widely known as “COPN.” Over the past several weeks, bills have made their way through their respective committees and onto the floor of the house, which seek to reform, to varying degrees, these laws, which significantly govern hospitals within the Commonwealth.
COPN laws were established in Virginia during the 1970’s in response to mandates imposed at that time by the federal government. With these federal mandates having since been repealed, Virginia remains one of more than 30 other states, which has retained this system of regulation. The regulations are extensive, covering nearly all aspects of health care. They include rules over emergency services, ambulatory surgical centers, and diagnostic imaging.
However, COPN is not restricted to health services. The laws also include regulations over a hospital’s capital expenditures and the ability for the entity to expand its facility or to build in a new location. Regardless of whether a health care provider seeks to add new services, alter existing services, or build a new facility, it must first make an application to the state government for an evaluation as to the “public need” warranting the issuance of a certificate of approval for the requested action.
Once an application is filed, the process to approve or disapprove the request is lengthy, approaching an entire calendar year for decision. A large fee must accompany the application, which currently makes its way through three different state agencies over multiple procedural steps. The advisability of these rules have been tolerated in past decades, but today, in the wake of the federally imposed Obamacare disaster, many voices are seeking ways to allow free markets to help lower costs and expand access to patients through COPN reform.
In our own community, we have seen how the COPN process restricted and delayed new facility construction, despite private party determinations of adequate supply and demand. Not very long ago, many of you took time to go to Richmond to give voice to our need for expanded access, and we all witnessed how competitors sought to use the system to gain an advantage over rival companies in a battle over imaging equipment. Most of us can agree that while economic competition is healthy, leveraging competitive advantage under the color of state power is counterproductive to the needs of society and is ultimately most harmful to the individual consumer.
For these and other reasons I have decided to support measures aimed at reforming COPN in Virginia. Studies have shown that the cost of health care in states with these laws are, on average, more than 10 percent higher than those without. It has been reported that under Obamacare approximately 250,000 Virginians have had their insurance cancelled, and as anyone who is insured can attest, premium costs continue to rise. Now more than ever, we need the savings and access that a free market can yield.