In September, Michigan’s Certificate of Need Commission voted to restrict access to a new, potentially lifesaving cancer treatment known as “CAR-T.” This FDA-approved procedure programs the body’s own T-cells to attack and kill cancerous cells, allowing patients to avoid invasive surgeries, chemotherapy and radiation. Why, then, would an unelected Michigan state board force health care providers and facilities to walk through more bureaucratic red tape that limits access to this treatment for many Michigan cancer patients?
Thirty-five states and the District of Columbia maintain certificate of need, or CON, laws, which require health care providers to seek permission from the state before they can open their practice, expand it, or invest in new equipment and technologies. Before obtaining this permission slip, the provider’s competitors — already operating in the same market space — can come before the state board or commission and challenge their would-be competitor’s case. As a result, there is in these states less competition for health care services, causing higher prices, reduced access and poorer patient outcomes. Indeed, CON laws are among the more abhorrent forms of corporate welfare. And thanks to Michigan’s CON Commission, this was the process that health care providers were required to walk through to make CAR-T accessible to patients in our state — that is, until the Mackinac Center and our allies successfully appealed to the Legislature to intervene and reverse the commission’s ruling.
Within 45 days of a CON Commission ruling, the Legislature has the power to step in and review — and even reverse — the ruling. Mackinac Center policy and government affairs experts met with lawmakers to discuss the potentially destructive impact that CON laws — and this ruling on CAR-T, in particular — have on patient access and health outcomes in our state. Fortunately, lawmakers acknowledged that the CON Commission overstepped and exceeded its purview of regulating the capital investments of health care facilities and attempted to interfere with patient access to an FDA-approved treatment that can be easily administered through routine blood transfusions.
In October, with just days left to act, the Michigan Legislature approved a joint resolution denouncing the CON Commission’s ruling on CAR-T and reversing it. This important victory for cancer patients across the state has set the stage for a broader consideration of CON reform over the coming months. Sweeping reform is certainly needed, as these laws are antiquated and proved to be ineffective — yet, have real consequences on patients’ access to critical services. Consider that research by the Mercatus Center estimates that:
- Michigan has approximately 12,900 fewer hospital beds due to CON restrictions.
- The state has between 20 to 40 fewer facilities offering MRI services.
- Between 68 to 85 fewer hospitals offer CT scans.
Should Michigan lawmakers embrace more serious reforms to CON laws over the coming months and year, patients will experience a positive impact on the accessibility, affordability and quality of care options across the state.