Jaimie Cavanaugh

senior state policy counsel @pacificlegal
views my own

[Jaimie Cavanaugh @jaimiecavanaugh]

Thanks for leading on this, Rhode Island!

[Reily 🍂 @reilyseanconn]

Proud of our CON reform in RI. More supply to lower healthcare costs. Exempts home health, behavioral health, imaging & ASCs; CapEx threshold now 50M, and more.

“Rhode Island enacted the most sweeping Certificate of Need repeal of any state during the 2026 legislative session.”

[Sam Hooper @LegeLawyer]

Great testimony by @jaimiecavanaugh before an Oklahoma interim committee on how @PacificLegal's Golden Girls Act (abolishing arbitrary occupancy limits based on relatedness) can increase housing supply, save people money, and even address the loneliness epidemic. #coliving

[Adam Bruggeman, MD @DrBruggeman]

History of CON Laws

New York enacted the nation's first certificate of need law in 1964. Within a decade, 26 more states had adopted similar programs. The intellectual foundation for these laws traces to Milton Roemer, a UCLA health services researcher who found in 1959 that hospital markets with more beds saw more days of inpatient care used by insured patients. He summarized the finding simply: a built bed is a filled bed. Policymakers read this as evidence that supply drives its own demand in a system insulated from normal price competition, and concluded that unchecked capital investment by hospitals would create a medical arms race and escalating costs.

Congress nationalized this approach in 1974 with the National Health Planning and Resources Development Act, which threatened to withhold federal health funding from any state that did not adopt a CON program. Nearly every state complied. The stated goals were to control runaway spending and to promote access to care in underserved areas.

By the mid 1980s, the evidence told a different story. Researchers found that CON laws were not restraining spending as promised and were instead limiting competition and entrenching incumbent providers (which ultimately led to consolidation and increased costs). Congress repealed the federal mandate in 1986. Roughly a dozen states repealed their own CON laws outright in the years that followed, including Arizona, California, Colorado, Idaho, Kansas, and Oklahoma. But in most states, the law stayed on the books long after the federal requirement disappeared, sustained largely by the same incumbent hospitals and health systems that benefit from having a veto over new competition (leading to further consolidation in those states).

That is the uncomfortable truth about CON laws today. They no longer exist because Washington mandates them. They are legal relics that exist because the parties who benefit from limiting competition have every incentive to keep them and those same parties have considerable lobbying resources to ensure their power never goes away.

[Jaimie Cavanaugh @jaimiecavanaugh]

@realdocspeaks I send out a quarterly newsletter on all things CON reform. Let me know if you'd like to be added to the list.

https://t.co/cdmgs3HoOk

[Jaimie Cavanaugh @jaimiecavanaugh]

@realdocspeaks @Knoxteaparty I send out a quarterly newsletter on all things CON. Send me your email if you'd like to be added!

[Candace Carroll @candacepcarroll]

Huge opportunity for South Carolina to lead on commonsense regulatory reform and support the small businesses that drive our economy.

@scsenategop and @SCSenateDems - a concurrence vote would get this bill over the finish line! Let’s get it done!

[Jaimie Cavanaugh @jaimiecavanaugh]

@ConnollyRoss Hospitals cause more of the problem than insurers: https://t.co/ngImLGBJ3H

[Matthew Mitchell @Matt_d_Mitchell]

There are lots of hysterical claims about what happens when CON regulations are repealed. Steve Slivinski & I wanted to see if any of them were true. Here's our latest, in the GMU Law Review: https://t.co/clHMLhW0kh

[Reily 🍂 @reilyseanconn]

Dr. @ashishkjha makes the case for key parts of @GovDanMcKee’s Affordability for All healthcare agenda: scaling back certificate of need laws and expanding scope of practice to lower costs, increase competition, and improve access. https://t.co/iH533nW1xO

[Josh Smith @smithtjosh]

"The path forward is clear: If we want more housing, lower costs, and cleaner energy, we must make it easier to build. Permitting should empower growth, not stifle it."

- @jaimiecavanaugh here at @PacificLegal

[M. Nolan Gray 🥑 @mnolangray]

Good for them. In addition to being legally dubious, charging an "affordable housing fee" to build more housing is incoherent policy.

[FITSNews @fitsnews]

🏛️⚖️ New #FITSForum piece from @JaimieCavanaugh of @PacificLegal on the importance of ending bureaucrats/regulators home-field advantage over citizens in South Carolina courts... https://t.co/7vdeEbnywR

[Matthew Mitchell @Matt_d_Mitchell]

Certificate-of-Need Laws Still Fail Patients — Even After a Decade of Reform.
https://t.co/hfEGqO59sG

[Jaimie Cavanaugh @jaimiecavanaugh]

Let's go KY! Time to reform certificate of need. #endtheCON #KYpol

https://t.co/kiCNquRw15

[Ashish K. Jha @ashishkjha]

So yeah, four simple policy ideas that are empirically grounded

Will lower spending
Improve access
And are very bipartisan

No, they won't solve all of our problems

There are no magic bullets in US healthcare

But this set of reforms would help a lot

https://t.co/GsatR2auO5

[Jaimie Cavanaugh @jaimiecavanaugh]

@DrDiGiorgio but healthcare systems are members of Chambers of Commerce

[Kite & Key Media @kiteandkeymedia]

States with certificate-of-need laws (which prevent hospitals from being built without government permission) have about 25% fewer hospital beds per capita than states that don’t have them.

[Candace Carroll @candacepcarroll]

🚨New Poll alert for the Small Business Regulatory Freedom Act (H 3021/S 254) and the support is strong! 💪

[Jaimie Cavanaugh @jaimiecavanaugh]

@SenRandPaul @DutchRojas In fact, keeping CON on the books in KY disadvantages the state in its application for some of the $50billion set aside in the rural healthcare transformation fund. You should be talking to state lawmakers about the importance of repeal.

[Jaimie Cavanaugh @jaimiecavanaugh]

@twilabrase How about this?
https://t.co/WBTP8mORRy