Two South Carolina lawmakers have introduced a bill that would eliminate a complex set of health care regulations that govern everything from new hospital construction to expensive medical equipment.
Rep. Nancy Mace, a Daniel Island Republican, said the state's Certificate of Need rules are outdated and impose "an enormous regulatory burden."
They also stifle competition and increase health care costs for patients, she said.
"Health care is a major issue for every family in the state of South Carolina. At the federal level, they’re not getting the job done," Mace said. "What can we do at the state level to improve health care for patients?"
Repealing the state's Certificate of Need laws will accomplish that, she argued.
The rules, which are administered by the S.C. Department of Health and Environmental Control, require health care providers to apply for permission to expand their facilities, build new ones and make equipment investments, such as new MRI machines.
DHEC, upon reviewing each request, either grants a Certificate of Need or denies the application.
The regulations are designed to prevent duplication of services — such as too many hospitals in one county, for example. Critics of the regulations argue they don't work as intended.
The bill, introduced in the S.C. House of Representatives on Thursday, is co-sponsored by Rep. Murrell Smith, a Sumter Republican. It has already received the endorsement of the Charleston County Medical Society.
Dr. Marcelo Hochman, the society's president, said the existing regulations grant "a virtual monopoly" to some businesses and prevent others from entering the market.
"A full repeal of the Certificate of Need laws will expand access, drive down prices and increase the quality of health care in South Carolina," Hochman said in a press release.
While health care providers have been generally split on the issue, the S.C. Hospital Association, which represents more than 60 hospitals in South Carolina, opposes full repeal of the state's Certificate of Need rules.
The regulations need to be modernized, association spokesman Schipp Ames said, but he added that "fully repealing our CON program would risk access in rural communities and put the state at a competitive disadvantage with neighboring states with more restrictive CON laws."
Ames further explained that South Carolina hospitals would have more difficulty expanding into neighboring states, while out-of-state health systems "would have unlimited ability to selectively offer only the services that generate revenue."
Mace's bill isn't the first attempt to eliminate the Certificate of Need rules.
Former Gov. Nikki Haley vetoed funding for the program in 2013. The state Supreme Court later ruled DHEC was obligated to administer the rules with or without money in the agency's budget.
Other proposed bills have been introduced since then to phase out the program but have failed to become law.