Thousands of dollars in application fees, litigation, and a difficult application process all prevent better health outcomes in West Virginia . The culprit? Certificate of need: a regulation that mandates government approval before a healthcare facility may be built or add services. States are beginning to review the outdated health policy that has inhibited effective, accessible care for thousands of patients across the nation. The Mountain State is among those fighting to carve away at the law this year.

In West Virginia, to expand or build a new healthcare service or facility, one must receive permission from the West Virginia Health Care Authority to do so. But unlike most regulatory reviews, the process fails to consider quality, standards for care, or safety. Rather, the regulation strictly reviews anticipated investments of a prospective provider and possible commercial impacts on existing regional providers. The agency, and proponents of the regulation, claim this system is a regulatory element that helps to control cost, improve the quality of the healthcare system, and develop a system to provide the most care to the most people. They’re grossly misled.

According to a study from the Kaiser Family Foundation, states with certificate-of-need laws have healthcare costs 11% higher than states without. The Mercatus Center at George Mason University also found a 5.5% higher mortality rate, fewer hospital beds (131 fewer per 100,000), fewer MRI machines, and less access to CT scans.

By providing consideration and veto power to competitors in the area, certificate of need protects a scheme that allows government, not consumers, to determine the fate of the healthcare market and artificially balloons cost and reduces quality. In West Virginia, the impact of this law has been dire: 53 out of 55 counties in the state today face a healthcare shortage.

However, significant shifts in the conversation around the regulation have paved the way for potential skinny reforms in West Virginia’s legislative session. Senate Bill 613 is currently moving through the legislative process to tackle the issues presented by the regulation for two specific industries: hospitals and birthing centers. The bill would exempt hospitals from seeking certificates of need for new services, including preventive care, diagnostic services, and treatment or rehabilitative services on a hospital’s campus. It would also make acquiring a certificate of need unnecessary for some ambulatory services, dependent on them being located on a hospital’s campus, and would also remove requirements for birthing centers. This last one is especially important because West Virginia only has one birthing center in the entire state.

Notably, the Centers for Disease Control and Prevention shows West Virginia ranks ninth in the nation for low birth rate, fourth for preterm births, and fourth for its infant mortality rate. The March of Dimes has also given the state an F for its preterm birth rate and indicates that nearly half of all counties in West Virginia are maternity care deserts.

The research on certificate of need has made one thing clear: West Virginians would greatly benefit from the elimination of this regulation. Yet if self-interested bureaucrats continue to ignore the truths about a policy that creates an environment motivated by profits over people, debate on the issue will always be an uphill battle.

Still, state legislators have a responsibility to act. By eliminating certificate of need, West Virginia has the opportunity to put forth forward-thinking policies that rightfully put patients first.

Jessica Dobrinsky Harris is a policy analyst at the Cardinal Institute for WV Policy.