Often, a state accepting federal dollars does so with strings attached. Unfortunately, old habits die hard. Even when federal law changes and the strings are severed, programs created by those laws have a pesky habit of sticking around and are rarely repealed by state lawmakers. Frequently, this comes at a greater cost to consumers, taxpayers, or both.
West Virginia is only the latest state to take the step of eliminating restrictive barriers to health care, and Iowa should be the next. Policymakers in Iowa can increase access to health care and improve affordability by eliminating excessive restrictions on the expansion and introduction of facilities. Specifically, Iowa’s Certificate of Need (CON) laws limit patient access and provider competit...
CON laws have decreased competition in Iowa’s healthcare field, resulting in higher medical costs and reduced healthcare access. The news has recently been telling stories about Iowa nursing homes closing and rural hospitals at risk. Iowans are facing higher healthcare costs and fewer options, and one reason is an extremely burdensome regulation called Certificate of Need, or CON. Healthcare provi...
The COVID-19 pandemic has impacted Iowa’s rural hospitals. The Iowa Hospital Association has estimated, the “state’s 118 hospitals, collectively, could lose as much as $2.17 billion in revenue by the end of this year.” A significant reason for this potential loss is, during the start of the pandemic, hospitals were not providing elective surgeries and other procedures. “Most of the […]
Research comparing states with and without Certificate of Need (CON) laws suggests CON requirements can limit competition and reduce access to rural health care services. During the 2026 legislative session, Iowa passed significant CON reforms that reduce regulatory barriers and narrow the number of projects requiring state approval. The reforms should make it easier for providers to expand servic...
Iowa’s Certificate of Need (CON) laws restrict when providers can build, expand, or add services, requiring state approval for major projects and expenditures. The process protects incumbent providers from competition. Recent proposals would significantly narrow CON requirements. Senator Kara Warme’s broad reform bill cleared the first legislative funnel by being passed out of Committee last week....
Iowa’s Certificate of Need law has failed its original purpose, acting as a barrier to access, competition, and innovation by allowing existing providers to block new services and facilities—often to the detriment of patients. Two Senate bills this session represent the most meaningful CON reform in years, easing restrictions on mental health facility expansion and sharply narrowing when CON revie...
Regulations, just as with high tax rates, deter economic growth and create roadblocks for an individual’s right to earn a living or for an entrepreneur to start a business. Governments have the instinct of a vegetable, according to President Herbert Hoover. Iowa’s own Oval Office resident explained that “they keep spreading and growing.” This is an accurate description, especially as [&helli...
While some regulation is necessary, too much stifles economic growth. The elimination of “red tape” barriers will add to and amplify the multiple pro-growth and free-market reforms Iowa has passed in recent years. Cutting back unnecessary regulation will continue to move Iowa toward a better economic climate.
Removing Certificate of Need requirements would put more services within reach of Iowans and help slow down the rising costs of health care in our state. Earlier this spring, we told you how West Virginia passed legislation repealing several provisions of its Certificate of Need (CON) Laws. As we wrote then, “the purpose of a CON law is to regulate […]
Increasing access to quality health care in Iowa is a priority. Sadly, rural hospitals suffered during the COVID-19 pandemic as many could not offer out-patient procedures, which resulted in a major financial loss and forced some patients to go without care. Many rural hospitals also closed maternity wards and more mental health care providers are needed. To increase access to […]
The Des Moines metro is growing and evidence of this growth can be seen through numerous construction and building projects. Recently, MercyOne hospital in West Des Moines announced a $13 million project to create a new maternity and infants care center. This is in response to the demands of a growing population. MercyOne is filling a need by meeting the […]
Certificate of Need laws not only prevent competition but work to limit health care services and increase medical costs for Iowans. The purpose of a Certificate of Need (CON) law is to regulate (limit) health care supply unless a need is determined by a state government agency or board. When CON laws were introduced in the 1970s, it was hoped […]
The Iowa legislature is currently considering three major property tax reform measures. Each of the proposed measures contains a provision that would cap the growth of property taxes at or around 2%. In response, local governments are sounding the alarm that placing a 2% property tax cap would endanger vital services such as police and fire. This argument is nothing new, and the familiar chorus h...
Chris Ingstad President Chris Ingstad is an eighth-generation Iowan who leads ITR Foundation, his state’s pro-growth, free-market think tank. He joined the Foundation as President and CEO in June 2022 after ten years working for Iowans for Tax Relief, serving as its President from 2016 to 2022. Under his leadership, Iowans for Tax Relief, a 501(c)(4) organization, played a ke...
By Matthew D. Mitchell, Senior Research Fellow, Mercatus Center COVID-19 presents a challenge of extraordinary scale and complexity. State policymakers across the country, like so many of us, want to know what they can do to help our nation’s healthcare professionals rise to this challenge. Their first task should be to eliminate or suspend laws that stand in the […]