House Bill To Repeal CON Law Fails By One Vote

One of the most debated and discussed bills of the 2025 legislative session failed to pass its committee by one vote Monday afternoon.

House Bill 2007 bill failed to leave the committee on a roll call vote 12 to 13.

A similar bill, Senate Bill 453, is being considered by the Senate’s Health and Human Resources committee. The bill was introduced and referred to the health committee on Feb. 13 but has yet to be placed on an agenda.

In past sessions, lawmakers have introduced bill after bill in an attempt to repeal a regulatory process required to expand health care services called certificate of need (CON).

CON is a regulatory process, overseen by the West Virginia Health Care Authority (WVHCA), that requires providers who want to create or expand healthcare services to obtain legal documentation proving those new services fit an unmet need in the area.

This session’s version is House Bill 2007, which aimed to repeal the CON process and terminate the WVHCA, leaving those decisions to the incoming secretary of the Department of Health, Dr. Arvin Singh and Attorney General John “JB” McCuskey.

Both Singh and McCuskey are new to their positions. McCuskey was elected to his position, and Singh was appointed by Gov. Patrick Morrisey after he was elected the state’s 37th governor in November 2024.

The repeal of CON is a major priority for Morrisey, as he outlined in his State of the State address Feb. 12., with the stated purpose being to restrict duplicative services.

“It’s essentially a permission slip, it’s given out by the government, that you need to open up a new hospital or healthcare facility,” Morrisey said. “It hands over power to unelected bureaucrats and major healthcare providers who decide which committee communities need new or expanded healthcare services. This is big government activism at its worst.”

The House’s Health and Human Resources Committee discussed the original version of the bill at length in a hearing on Feb. 20 where lawmakers heard differing opinions from several presenters.

Singh was the first presenter called to speak to the committee on Thursday afternoon.

“By putting CON decisions in the hands of bureaucrats, we are artificially inflating costs and determining winners or losers, leading to negative impacts to patient care,” Singh said. “This must change, and that starts with the repeal of CON laws and the Health Care Authority.”

Singh argued that repealing West Virginia’s CON laws would allow for new providers to offer more services without government regulation, which he and other proponents of repealing the law say would allow for competition in the healthcare industry, possibly leading to innovation.

Throughout the five-hour-long discussion, delegates from some of the state’s more rural regions expressed concern that competition, if it does occur, will be focused on the state’s more densely populated areas, worsening their regions’ lack of access to adequate care.

Del. Jeffrey Stephens, R-Marshall, asked about the possibility of further hindering rural area’s access to quality health care if CON is repealed.

“West Virginia, being a rural state, you know, some of us are from more populous areas like myself that, I mean, I can go to a lot of places, I can be within three hospitals within 10 minutes,” Stephens said. “I think if you’re going to be a business person, the surgical center or the hospital or anything like that, I’m going to go to where the population is.”

Del. Mike Pushkin, D-Kanawha, and minority chair of the committee expressed concerns about viewing the healthcare industry as a business during Singh’s testimony.

“You said, like any other business, it’s up to that,” Pushkin said. “That’s what you said.”

“I don’t think health care is like any other business,” Singh answered. “It deals with people’s lives. It’s a very, very important industry.”

Delegates heard from 13 speakers in total at the Feb. 20 hearing. Witnesses ranged in representation from hospitals like West Virginia University Medicine, Memorial Health System, Valley Health and Mon Health, all of whom hold differing views on CON repeal. There were also representatives from research institutes across the country offering their expertise.

Del. Jonathan Pinson, R-Mason, expressed some frustration with all the contradictory testimony the committee heard.

“I think myself and several other members of the committee are kind of left in the same spot in that we have half of this discussion telling us that competition is going to destroy the market, that it’s going to destroy the healthcare industry in the state of West Virginia if we repeal CON,” Pinson said. “And then we have the other half (of) the discussion telling us the only way to improve the health outcomes, the health industry in the state of West Virginia is to improve the market by repealing CON.” We’re left right here in the middle trying to figure out everybody’s facts and which facts are actually facts, and which facts are conjecture.”

Monday’s Roll Call Vote

On Monday, lawmakers voted on a committee substitute for House Bill 2007 that would have continued the state’s moratorium on certain services, such as nursing homes, intermediate care facilities, methadone beds, substance abuse treatment beds and hospice care.

The number of beds allowed in those types of facilities would also remain regulated under House Bill 2007. For example, West Virginia’s limitation of 250 licensed substance abuse treatment beds is maintained in the legislation.

Pushkin asked legislative counsel to clarify the moratorium and its relation to CON regulations.

“Certificate of need still exists, Delegate, but the Secretary is prohibited from issuing a certificate for the development of these services,” Legislative Counsel explained.

Pushkin asked counsel if a facility that provides any of the services under the moratorium closed, would another be able to take its place?

“I’m still kind of hung up on this moratorium thing, of this way of dealing with carve-outs, of just creating these new moratoriums,” he said. “If a hospice wasn’t doing so well, then another agency purchased them, would that be allowed under this law?”

Counsel explained that under this legislation, it would take legislative action to allow for a new facility to open.

Pinson expressed similar concerns.

“If West Virginia’s population were to increase, and we realized that there was a greater need for some of these services, the legislature would have to go in and increase the number?”

Counsel confirmed legislative action would be required to replace a facility that falls under the moratorium laid out in the committee substitute for House Bill 2007.

Pushkin moved to amend the bill to remove West Virginia’s moratorium on the opening of additional methadone clinics, which was passed into law in 2007. 

There are currently nine methadone clinics allowed to operate in the state by law. Pushkin said that seven of those facilities are owned by an out-of-state company, which he argued proved the moratorium put in place almost 20 years ago did not stir competition but created a monopoly.

“What you have right now with the methadone clinics is one company from, I believe, from Ohio, that makes a lot of money off of West Virginian’s misery and sends all that money to Ohio,” he said. “I think that while we’re dealing with this would be a good time to correct that mistake that was made years ago and created this monopoly in this state, really not very well regulated monopoly at that where patients are treated, not so much like patients, but more like cattle.”

Lawmakers rejected Pushkin’s amendment via voice vote.

Pushkin moved to table the bill, calling it “flawed” and “not well thought out,” and said he thinks it needs more work. The motion was rejected.