Needs to Go: Certificate of Need

It is time to reform or eliminate Iowa’s outdated certificate of need (CON) law. When Iowa’s CON law was implemented in the 1970s, it was thought that it would reduce healthcare costs by preventing unnecessary medical facility expansions. Unfortunately, the effect that CON laws have in practice is decreased competition in the healthcare field, resulting in higher medical costs and reduced healthcare access.

During the COVID-19 pandemic, Governor Kim Reynolds temporarily suspended Iowa’s CON law so that healthcare facilities could quickly and efficiently upgrade facilities to meet growing and changing demand. We witnessed Iowa’s healthcare facilities adapt. We heard the media cry out about disastrous shortages of ICU beds and hospital beds, yet during the height of the pandemic, medical facilities adapted and continued taking in patients. When the demands grew and changed, with the suspension of the government-mandated healthcare monopoly system Iowa utilizes, the medical community adapted under the temporary free market provisions within the emergency declaration.

Forty-five years of CON law has not made healthcare in Iowa better or less expensive. Rather, healthcare costs have skyrocketed, thanks in part to limited competition to drive down prices. Further, access to healthcare has decreased, particularly in rural areas, leaving people driving long distances to receive care. It’s time to end this government-mandated monopoly and let the free market address these healthcare problems. It’s time to repeal Iowa’s CON law.