CHARLESTON — In a blow to a major agenda item proposed by Gov. Patrick Morrisey, lawmakers in a West Virginia House of Delegates committee voted down yet another attempt to repeal the state’s certificate of need program for health care services.

The House Health and Human Resources Committee voted down a committee substitute for House Bill 2007, repealing the certificate of need (CON) program, in a 12-13 vote Monday afternoon.

Later Monday evening, an attempt was made to reconsider the vote in committee on HB 2007, a parliamentary motion that can only be made once, ensuring that the House bill cannot be taken up in the future. Committee members rejected the reconsideration motion.

The amended bill would have eliminated the CON program and the state Health Care Authority – the state agency that approves CON requests – effective Jan. 1, 2026. The committee substitute also would have continued the moratorium placed within the CON program for nursing home facilities and beds, intermediate care facilities and beds, methadone clinics, licensed substance use treatment beds, and hospice care.

“The fight to repeal Certificate of Need is not over,” Morrisey said in a post on social media Monday evening. “West Virginia currently pays more for hospital services than all but one state — while experiencing the worst healthcare outcomes. We must reduce the unaffordable price of healthcare and increase consumers’ access to the services they depend on.”

HB 2007 was introduced on Feb. 18 on behalf of Morrisey, who campaigned on eliminating CON last year. During his State of the State address on the first day of the 2025 legislative session on Feb. 12, Morrisey urged lawmakers to consider a CON repeal.

“West Virginia needs a much more competitive health care environment. We must repeal Certificate of Need mandates and allow innovation and entrepreneurship to take root,” Morrisey said. “We must also reform how we look at health care in West Virginia. Right now, our public health statistics rank lower than any other state in America. One of the roadblocks to improving our health care system is the Certificate of Need process.”

West Virginia’s CON law was put in place by lawmakers in 1977, making it one of 35 states with such laws. According to the National Conference of State Legislatures, only 12 states have fully repealed their CON programs. States began implementing CON programs to help control health care costs and prohibit duplicative or unneeded medical services in communities.

This is the third attempt to repeal the state’s CON program. A similar effort failed to get out of the House Health Committee two years ago. Last year, a bill managed to get out of the House Health Committee but was never taken up by the full House. Lawmakers have also passed targeted CON repeals, such as for birthing centers, in 2023.

During the first phase of the bill before the House Health Committee last Thursday, lawmakers heard testimony from supporters and opponents of repealing the CON program. Dr. Arvin Singh, the new cabinet secretary of the state Department of Health, said he has extensive experience submitting requests for certificates of need on behalf of hospitals, and CON puts up barriers to health care access.

“In West Virginia, we have the worst of two worlds,” Singh said. “Private businesses and employees pay extraordinarily high prices for health care, yet our citizens get an unacceptable return on investment with some of the worst health outcomes in the country in nearly every category. By putting CON decisions in the hands of bureaucrats, we are artificially inflating costs and determining winners and losers, leading to negative impacts to patient care.”

Dr. Dan Breece is the vice president of physician services and chief medical officer for the Memorial Health System based in Marietta, Ohio. Physicians in the Memorial Health System see many residents from border counties, such as Wood and Pleasants counties.

While Tyler County-based Sistersville Memorial Hospital is now part of the Memorial Health System and grandfathered in due to being a federal critical access hospital, Breece said the Memorial Health System is hindered from being able to offer other health care services across the river in the Mid-Ohio Valley, which was once home to as many as four hospitals.

“Our journey with CON has been so challenging that we’ve had to make strategic decisions which have probably hurt certain areas of West Virginia where we would have been wanting to invest dollars in that area,” Breece said.

According to a study released on Feb. 12 by the Journal of the American Medical Association, 44% of Medicare patients in rural regions of the U.S. report having to drive more than an hour for surgical services, driven by the closure of rural hospitals and other health care providers.

But Candace Miller, the CEO for WVU Medicine Jackson General Hospital, said West Virginia’s health care market makes repealing CON trickier. West Virginia has 72 hospitals, with 21 hospitals with a federal critical access designation. And 75% of the population in West Virginia relies on Medicare, Medicaid, and state worker health insurance through the Public Employees Insurance Agency – all three with low reimbursement rates.

“I have lived in West Virginia my entire life. Up until recently, I have worked in Ohio. And I will tell you, West Virginia is different,” Miller said. “In my humble opinion, we must recognize that there is work to do such as addressing supply and demand and creating a truly free market before moving towards CON repeal.

“I urge you to please make the choice to protect a certificate of need so it protects my critical access hospital designation because without it, my critical access hospital designation is at risk and so is my ability to keep the doors open,” Miller continued.