Rhode Island rolls back barriers to healthcare access
June 15, 2026
Providence, Rhode Island; June 15, 2026: Gov. Dan McKee signed Rhode Island’s state budget on Friday, enacting a significant rollback of the state’s determination of need laws, commonly known elsewhere as certificate of need laws, which strangle the supply of medical services in an anti-competitive bureaucracy. The legislation eliminates the government approval requirement for medical equipment purchases, raises the expenditure threshold for new facility construction to $50 million, and removes home health agencies, drug and alcohol abuse treatment centers, ambulatory surgery centers, and inpatient hospice facilities from the categories of facilities subject to review.
“Determination of need laws don’t protect patients — they protect incumbents,” said Jaimie Cavanaugh, senior state policy counsel with Pacific Legal Foundation. “Rhode Island families deserve access to the care they need, and that means letting providers build, compete, and innovate without forcing them to first get permission from their competitors.”
Rhode Island’s determination of need program required healthcare providers to prove a “need” for new services before regulators would allow them to open. Existing hospitals and health systems participated in the review process, giving them direct influence over whether competitors could enter the market. Today’s reform removes that barrier for a broad range of services while retaining oversight for a narrow category of specialized procedures, including cardiac catheterization, open heart surgery, organ transplants, particle accelerator radiation therapy, and neonatal intensive care.
The reforms were enacted as part of Rhode Island’s fiscal year 2027 budget. Pacific Legal Foundation worked alongside Gov. McKee’s office, Americans for Prosperity, and the Institute for Justice to advance the legislation. PLF works to roll back certificate of need laws nationwide as part of its broader fight against government regulations that block access to essential services.
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About Pacific Legal Foundation
Pacific Legal Foundation is a national nonprofit law firm that defends Americans threatened by government overreach and abuse. Since our founding in 1973, we challenge the government when it violates individual liberty and constitutional rights. With active cases in 34 states plus Washington, D.C., PLF represents clients in state and federal courts, with 18 wins of 21 cases litigated at the U.S. Supreme Court.