Lawmakers, doctors pushing bill to make it easier for hospitals to open, expand

COLUMBIA, S.C. (WIS) - Lawmakers want to make a major change to South Carolina’s healthcare system that they say will make care more affordable and accessible.

S. 290, which currently has bipartisan backing, would repeal South Carolina’s Certificate of Need, or CON, law. The Palmetto State is one of more than 30 states with this type of legislation in place at this point.

Under a CON law, if someone wants to build a new hospital, or if an existing hospital wants to expand or even purchase new, larger pieces of medical machinery, they must get approval from the state through the South Carolina Department of Health and Environmental Control.

As part of this process, existing hospitals can block other hospitals’ projects.

“Imagine if we had a CON in the grocery industry, and Farmer Smith decided that he wanted to sell corn or tomatoes or other produce. What if Publix or Harris Teeter could raise their hand and say, ‘I object,’ and block that project?” Dr. Rob Brown, an ENT surgeon from Greenville, said.

Brown is among a group of doctors backing lawmakers for this change, which they said will allow physicians to open more facilities outside the umbrella of larger hospital groups.

Critics of the CON law said the legislation has led to more healthcare monopolies and higher costs for patients.

“Repealing this law is the only thing that makes sense,” Dr. Marcelo Hochman, a facial plastic surgeon from Charleston County, said, noting people wanting to build hospitals would still need to go about being properly licensed and appropriately financed.

Gov. Henry McMaster suspended the state’s CON law in 2020 to allow hospitals to add more beds and care for an influx of patients during COVID spikes.

“We did not fall apart. We did just fine last year,” Sen. Penry Gustafson, R – Kershaw, said.

The South Carolina Hospital Association believes the Certificate of Need law needs to be amended but should not be completely tossed.

“Certificate of Need rules are there to protect patients. CON rules protect access to care in rural communities and for low-income households,” SCHA Executive Vice President Christian Soura said.

Soura said the law should be changed to reduce the amount of time it takes to get decisions and cut down on the number of projects that require CON approval, among other adjustments.

“We went and looked at the last five years’ worth of Certificate of Need applications, and if the hospital community’s reform proposal had been in place, we would’ve been able to cut the number of CON applications by more than two-thirds,” Soura said.

Supporters of the CON repeal argued the move would improve healthcare accessibility in rural areas.

Senators began debating the CON bill Wednesday in what they expect will be a multi-day debate that was scheduled to resume the next day. But Thursday, Senate Majority Leader Shane Massey, R – Edgefield, said conversations about the legislation would likely be happening over the weekend, so senators will pick the debate up when they return to the State House on Tuesday.

If the Senate does pass S. 290, the bill would head to the House of Representatives, where it would need to be approved three more times before heading to the governor’s desk.

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