(Reporter's Notebook by Steven Allen Adams - Photo Illustration - MetroCreativeConnection)

Here we go again, the merry-go-round that simply will not end.

If it seems like I’ve written a whole column on the efforts by some to eliminate West Virginia’s certificate of need law, I did back in March. Remember, I got to shoehorn in a “Star Trek II: The Wrath of Khan” reference. But supporters and detractors of CON repeal were back at it last week.

Once again, many health care services are required to apply for a certificate of need from the state, which can approve or reject it based on many factors, such as the availability of similar services in the region.

Gov. Patrick Morrisey had bills introduced on his behalf during the 2025 legislative session to repeal the CON law. However, the House Health and Human Resources Committee voted down a committee substitute for House Bill 2007, repealing the CON program, in a 12-13 vote. The Senate wouldn’t even put their version of the bill on a committee agenda. This makes the third year that an effort to repeal CON went down in flames.

My friends Dave Wilson and T.J. Meadows of WV MetroNews Talkline had on former Senate President Craig Blair last Tuesday, who penned an op-ed recently supporting a potential repeal of CON in the future, but making the case that West Virginia isn’t ready to rip the bandage off just yet.

“…Here’s the uncomfortable truth: Eliminating the certificate of need for health care in West Virginia simply won’t work,” Blair wrote. “Not now. Not in the economic and demographic conditions we currently face. In fact, doing so would deepen our existing crises and unravel the fragile safety net that holds rural health care together.”

Jessica Dobrinsky, the chief of staff of the conservative Cardinal Institute for West Virginia Policy, was on Talkline Wednesday to provide the counterpoint. In a January article on the Cardinal Institute’s website she defended the need for CON repeal.

“…These laws have proven to be barriers that block progress and deny access to care,” Dobrinsky wrote. “CON laws have devolved into protectionist policies that harm competition, restrict innovation, and deny critical care to rural communities… Full repeal is not just necessary–it is the only path forward.”

I’ll put my cards on the table and say that while I am supportive of certificate of need going away in West Virginia, I am probably closer to the position of Blair than I am Dobrinsky.

As long as West Virginians remain largely dependent on Medicaid, Medicare and other forms of subsidized health care, and as long as the state keeps losing population, I’m doubtful that repealing CON will create the increase in services and decrease in health care costs that CON repeal advocates believe it would.

That doesn’t mean that parts of the state wouldn’t benefit from CON repeal. The Eastern Panhandle, for example, is growing fast and could probably use more health care services to keep up. That’s why I wish Cardinal and the West Virginia chapter of Americans for Prosperity would be open to either a CON repeal pilot or a slow phase-out of the CON program.

While Morrisey and his staff ran into issues early in the legislative session using the stick, Morrisey is now trying to use the carrot in the hopes of bringing lawmakers on board for CON repeal next year. During a press conference last Wednesday, I asked Morrisey about trying again for CON repeal. He told me to stay tuned for some announcements regarding CON in the next few weeks.

“There are a lot of different ways that we can make the health care environment in West Virginia more competitive,” Morrisey said. “You’d like to get a law in place. That’s the long-term arc of it. I do think that the majority of the Legislature, when given an opportunity, would want to see advancements in those areas.

“I know that different parts of the state are kind of crying out for more competition, and so I hear that, I see that. We’re going to continue to look at that,” Morrisey continued. “I think people who know me know that I try to look long-term. I don’t put ideas out there that I don’t intend to follow through on. I think people know that. We certainly know the value of competition, and we want to make sure that we’re improving health care quality and outcomes in the state.”

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Gov. Morrisey deserves credit for the plans he rolled out last week regarding the state’s foster care system and Child Protective Services, especially when it comes to greater transparency regarding child fatalities and near-fatalities.

Quite frankly, former Gov. Jim Justice’s Department of Human Services (previously the Department of Health and Human Resources) was very hostile toward the press, which in turn caused us in the media to further scrutinize the department. Justice’s DoHS was less concerned about children and more concerned about avoiding bad headlines. As a result, they failed kids and failed to avoid bad headlines.

But now, it will be up to the press to hold the Morrisey administration accountable to its new plans and policies. The system is still underfunded and understaffed. New DoHS Cabinet Secretary Alex Mayer just wrapped up a listening tour around the state to gain feedback on the issues with foster care and CPS. It appears that the administration is listening and taking initial action.

Steven Allen Adams can be reached at sadams@newsandsentinel.com