What is a Certificate of Need?

In some industries, new businesses must apply for a license or “certificate” to prove that their service is “needed.” This is a long, tedious process that is unrelated to health and safety concerns.

Existing businesses that hold a certificate are invited to testify about whether they think new competition is desirable. That’s an obvious conflict of interest. And certificate holders enjoy a “competitor’s veto” power over new competition because the government often defers to their objections to new businesses.

“Competitor’s veto” laws limit the supply of services, mostly in the healthcare industry, including hospitals, birthing centers, home healthcare providers, MRI machines, nursing homes, and ambulances. These laws are also common in the transportation industry—over half of states require moving companies to obtain a Certificate of Need.

In courts and legislatures, Pacific Legal Foundation fights to liberate entrepreneurs and roll back Certificate of Need laws.

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In courts and legislatures, Pacific Legal Foundation fights to liberate entrepreneurs and roll back Certificate of Need laws.

Thirty-nine states and the District of Columbia have CON laws for at least one medical service.

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Competitor’s Veto: A Roadblock to New Businesses, a review of CON laws in the moving industry.

March 22, 2024

Economic opportunity matters, too

PLF fights against laws that keep entrepreneurs from providing their much-needed services. For example, we represent Katie Chubb in challenging Georgia’s certificate-of-need law, which prevents her …

September 14, 2023 | By LARRY SALZMAN

The Dispatch: The Supreme Court Can Fix Its Oldest Mistake This Year

Ursula Newell-Davis has been a social worker in New Orleans for more than 20 years with a particular passion for special needs children (including her own), so she knows special needs families are oft…

November 30, 2022 | By ERIC SHEAR

Choosing the Gatekeepers

One out of every four workers is not allowed to do their job without an official state-issued license. Licensing boards, using government power, control the marketplace for services in their industrie…

September 1, 2022 | By ANASTASIA BODEN

In a recent lawsuit, the Louisiana Department of Health admitted what every parent of a special needs child knows: There is always a need for more care for this population. Parents need time away from the rigors of child-rearing, whether it be to work, run errands, or simply have time to themselves.

One out of every four workers is not allowed to do their job without an official state-issued license. Licensing boards, using government power, control the marketplace for services in their industrie…

August 23, 2021 | By ANASTASIA BODEN

The Hill: Biden’s economic reform ought to consider certificate of need, too

President Biden recently called on the federal government to increase competition in the U.S. economy as a way of boosting wages, increasing employment, and allowing people to move between jobs. One o…

December 20, 2023 | By BRITTANY HUNTER

Pacific Legal Foundation's 2023 highlights

December 19, 2023 | By BRITTANY HUNTER

When government gets between a mother and a midwife

October 11, 2023 | By BRITTANY HUNTER

Why won’t SCOTUS protect economic liberty?

September 01, 2022 | By NICOLE W.C. YEATMAN

Government blocks much-needed birth center in Georgia

May 19, 2022 | By BRITTANY HUNTER

Reforming CON laws is a matter of life and death

August 19, 2020 | By NATHANIEL HAMILTON

States that suspended Certificate of Need laws saved lives

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Liberating America’s healthcare services has never been more important. Support PLF’s efforts to throw out these absurd and unconstitutional laws for good.

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