It feels like déjà vu. Once again, West Virginia lawmakers and policy advocates are caught in a familiar debate: whether to eliminate the state’s certificate of need (CON) law.
If it sounds like we’ve been here before, it’s because we have. Just a few months ago, this issue was front and center in Charleston. Despite repeated efforts, repeal proposals have fallen short—again. And the back-and-forth shows no signs of stopping.
What Is CON, and Why Does It Matter?
The certificate of need law requires healthcare providers to get state approval before expanding or launching new services. The idea is to prevent duplicate services, reduce costs, and ensure access in underserved areas. Critics argue, however, that it stifles competition and innovation—especially in fast-growing regions.
Governor Patrick Morrisey backed another push for repeal during the 2025 legislative session. His bill, House Bill 2007, didn’t get far. It was narrowly voted down 13-12 in the House Health and Human Resources Committee. The Senate didn’t even place its version of the bill on an agenda. That makes three straight years of failed attempts.
Two Sides of a Divided Debate
Former Senate President Craig Blair added his voice to the conversation, writing recently that while he supports eventual repeal, West Virginia isn’t ready yet.
“Eliminating the certificate of need simply won’t work under current conditions,” Blair warned, citing the fragile state of rural healthcare and economic pressures that make repeal risky in the short term.
On the other hand, conservative think tanks like the Cardinal Institute remain firm in their push to repeal CON now. Jessica Dobrinsky, the institute’s chief of staff, argues the laws hurt access, slow innovation, and shield providers from competition.
“Full repeal is not just necessary—it’s the only path forward,” she said during an interview last week.
Where the Public Stands—And What Might Work
Here’s where I land: I support phasing out the CON program, but not overnight. Blair’s caution makes sense. With much of the state still reliant on Medicaid and Medicare, and population trends moving in the wrong direction, a full repeal might not bring the boost that proponents predict.
Some parts of the state—like the fast-growing Eastern Panhandle—could clearly benefit from expanded healthcare options. But rural areas, where hospital closures are already a problem, could be hit hard if not handled carefully.
That’s why a pilot program or phased repeal could strike the right balance. Let’s test the waters before diving in headfirst.
Morrisey Isn’t Backing Down
To his credit, Gov. Morrisey is staying persistent. At a press conference last week, he signaled that more news on this issue is coming soon.
“There are different ways we can make healthcare more competitive in West Virginia,” Morrisey said. “We know the value of competition. We want better quality and better outcomes for West Virginians.”
He also acknowledged that some areas are “crying out” for more healthcare options, hinting at a more targeted approach this time around.
A New Approach to Child Welfare
Alongside the CON debate, Morrisey also unveiled plans to reform the state’s foster care system and Child Protective Services (CPS). One major shift? Greater transparency about child fatalities and near-fatalities—a stark contrast from the past.
Under former Governor Jim Justice’s administration, the Department of Human Services was notoriously tight-lipped with the media. That lack of transparency created more scrutiny, more mistrust, and—most importantly—left vulnerable children at risk.
Now, under new DHS Secretary Alex Mayer, the Morrisey administration appears to be listening. Mayer just wrapped up a statewide listening tour to understand CPS challenges firsthand.
This is a promising step. But as always, it will be up to reporters—and the public—to hold the government accountable as new policies roll out.
