Certificate-of-Need Laws: Implications for New Hampshire
Thirty-five states and the District of Columbia currently limit entry or expansion of health care facilities through certificate-of-need programs which prohibit health care providers from entering new markets or making changes to their existing capacity without the approval of state regulators. New Hampshire requires a certificate of need from the state before any of 12 devices or services are purchased and offered. Proponents claim that the limits were necessary to either control costs or increase the amount of charity care being provided. However, 40 years of evidence demonstrate that these programs do not achieve their intended outcomes, but rather decrease the supply and availability of health care services by limiting entry and competition. For policymakers in New Hampshire, this situation presents an opportunity to reverse course and open the market for greater entry, more competition, and ultimately more options for those seeking care.