RICHMOND — Three Republican members of Virginia’s House of Delegates on Monday called for a repeal of Virginia health-care laws that they say curb competition and stifle innovation.
The move reflects a national push to eliminate regulations that require state pre-approval of hospital expansions, surgery centers and certain medical services. Some hospitals say that the regulations, known as “certificate of public need” laws, prevent providers from artificially increasing prices and protect facilities that care for indigent patients.
Debate over health-care laws is expected to dominate the upcoming legislative session in Virginia as powerful players square off over how much regulation is appropriate.
Last week, Gov. Terry McAuliffe (D) said he has a plan to pay for Medicaid expansion with a 3 percent tax on hospital revenue. The idea was quickly panned by Republicans, who vowed for the third straight year to block efforts to cover 400,000 uninsured Virginians under the federal Affordable Care Act.
Three of those lawmakers — Del. John M. O’Bannon III (R-Henrico), Del. Kathy J. Byron (R-Bedford), Del. Christopher Kilian Peace (R-Hanover) — said Monday that they plan to file eight bills having to do with certification of public need.
“COPN gets used by respective systems to try to build monopolies,” O’Bannon, who is a neurologist, said of the regulations, which he said tie up applications in red tape.
His proposal would remove imaging, ambulatory and surgery centers and hospitals from the laws over three years but leave the regulations in place for nursing homes, open-heart surgery facilities and tissue transplant services.
The lawmakers said recommendations of a work group appointed by state Health Secretary William A. Hazel Jr. and chaired by Eva Hardy, a former health secretary, don’t go far enough.
A group of hospital chief executives and industry experts met for several months and decided to keep the laws essentially intact, although it suggested some changes to a process that can drag on for many months. The panel said that the application process should be streamlined to reduce the typical review to less than 120 days and that an expedited review that could approve projects in as little as 45 days should be established.
McAuliffe spokesman Brian Coy said the governor will review the GOP bills and make legislative proposals of his own.
The Virginia Hospital & Healthcare Association opposes efforts to roll back the laws.
“Going beyond [the report] would threaten our health care system that already faces challenges in making health care more affordable and more available to Virginians. That is too risky a proposition at this time,” VHHA spokesman Julian Walker said in a statement.
Inova, Northern Virginia’s largest hospital system, said it agreed rolling back certain parts of the law would not work.
“Inova supports reforms that seek to improve the COPN application and review process, and continues to oppose piecemeal deregulation of the commonwealth’s long-standing COPN program,” Inova spokesman Roger A. “Tony” Raker said in a statement.
Nationwide, support and opposition to certificate of public need laws do not fall neatly along partisan lines.
Christopher Koopman, a research fellow at the Mercatus Center at George Mason University, said that bills to change or eliminate certificate of public need laws were introduced in 19 states in their most recent legislative sessions.
Florida Gov. Rick Scott (R) opposes the laws. So do some federal agencies: The Federal Trade Commission and the antitrust division of the U.S. Justice Department in October panned the laws for limiting consumer choice, among other criticisms.
Calls for reform are the result of a common dissatisfaction with access to and the quality of health care, Koopman said.
“States are realizing there are real things they can do to make substantive changes to their health-care markets immediately and no longer wait for the federal government to do this,” he said. “And, second, states are getting tired of waiting for the federal government.”
House Speaker William J. Howell (R-Stafford) said changes are needed but declined to favor one GOP proposal over another.
“The speaker is supportive and feels there’s strong appetite for COPN reform in the House,” Howell spokesman Matt Moran said. “However, it’s a complicated issue and will have to work its way through the legislative process.”