Rising healthcare costs are a concern for many North Carolina residents, including some members of the state legislature who are pushing a proposal that they say could help make care more affordable for consumers.<\/p>\n
Their idea: repealing some of the state\u2019s \u201ccertificate-of-need\u201d laws, which regulate competition for healthcare services across the state. The proposal is sure to face strong opposition from the hospital industry, which has succeeded in killing similar efforts in the past. Supporters, however, hope this year could be different.<\/p>\n
They\u2019re seeking to channel political concerns around growing healthcare costs for state taxpayers \u2014 through Medicaid or the State Health Plan \u2014 as well for those on private health insurance. And they say a proposal for Raleigh-based WakeMed hospital to become part of a massive national hospital chain, run in part by Charlotte-based Atrium Health, will wind up raising costs for people on private insurance. Recent academic research shows hospital mergers and acquisitions tend to lead to higher prices.<\/p>\n
\u201cThey’re just going to raise prices, expand operating margin,\u201d state Treasurer Brad Briner, who opposes the WakeMed-Atrium partnership, told WRAL in an interview earlier this month. \u201cAnd ultimately, the patients will feel the brunt of that through higher prices.\u201d<\/p>\n
One possible way to combat rising health care costs could be finding cheaper ways to do surgeries. Supporters of repealing certificate-of-need laws say it\u2019ll do exactly that.<\/p>\n
\u201cIf we want to talk about costs and talk about saving dollars, this is a meaningful step that we can do to actually make that happen,\u201d Wilmington Republican state Sen. Michael Lee, the Senate majority leader, said Wednesday as he introduced his proposal in a Senate committee.<\/p>\n
Hospitals plan to stand in the way. A spokesperson for the North Carolina Healthcare Association, the state\u2019s leading hospital lobbying group, told WRAL on Wednesday that some of the piecemeal certificate-of-need repeals passed in 2023 \u2014 as part of a broader deal to authorize Medicaid expansion in the state \u2014 are still so recent that it\u2019s been impossible to analyze their impact, and therefore it would be premature to pass any new changes.<\/p>\n
\u201cIt will take time and meaningful data to assess how those changes affect access to care, hospital stability, and the availability of patient services across communities,\u201d said Stephanie Strickland, a spokeswoman for the hospital association. \u201cMoving forward with additional changes before that impact is understood could create unnecessary risk and unintended consequences for patients and North Carolina\u2019s broader healthcare system.\u201d<\/p>\n
\t\t\t\t\t\t\tCertificate-of-need laws<\/p>\n
Under the certificate-of-need system, the healthcare system in North Carolina doesn\u2019t operate in a free market. Rather, state officials decide how many hospital beds, or pieces of specific medical equipment, each county needs. Then doctors and hospitals fight over who gets to build those expansions or buy that equipment.<\/p>\n
Supporters say the system is meant to prevent out-of-control spending and keep costs down. Critics say it has had the opposite effect, allowing hospitals to stomp out competition and hike prices as a result.<\/p>\n
\u201cIt\u2019s a Soviet-style practice of controlling supply,\u201d Sen. Amy Galey, R-Alamance, said during Wednesday\u2019s hearing. \u201cAnd as the Soviet Union has fallen, I think CON should fall. We should tear down that wall.\u201d<\/p>\n
While hospitals have been mostly successful in killing efforts to repeal certificate-of-need laws, free-market advocates who favor reform hope this year could bring new political pressure to the fight.<\/p>\n
There\u2019s also looming legal pressure, after a state Supreme Court ruling in 2024 ordered a trial to determine whether the system is unconstitutional. Sen. Ralph Hise, R-Mitchell, said Wednesday he believes that courts will eventually strike down the certificate-of-need system as unconstitutional \u2014 and that hospitals should work now with the legislature to reform the system, rather than reacting after the fact to a potentially adverse court ruling.<\/p>\n
\u201cThis is an opportunity to get involved, and to plan the end of the CON process,\u201d Hise said.<\/p>\n