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38 states have certificate of need (CON) laws which make it illegal for healthcare providers to offer healthcare services to patients without first getting government permission. Defenders of CON laws assert that they are needed to control healthcare costs. However, these anti-competitive laws may violate a host of constitutional provisions, including state anti-monopoly clauses. Many courts have observed that CON laws are in fact anti-competitive but despite legal challenges, a majority of states have CON laws on the books today.

This episode discusses recent and current state CON law litigation, including the pending Singh v. North Carolina Dept of Health & Human Services matter.


  • Christina Sandefur, Executive Vice President, Goldwater Institute
  • Josh Windham, Attorney, Institute for Justice

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