Legislation aimed at lowering healthcare costs and expanding patient access to more affordable care options cleared the Senate Health Committee this week, advancing a proposal that will expand competition, lower costs, and give patients more access to lower-cost care settings.
Senate Bill 1040, championed by Senator Michael Lee, would repeal outdated Certificate of Need (CON) restrictions for ambulatory surgical centers (ASCs) and inpatient rehabilitation facilities — a reform that would increase competition, reduce healthcare spending, and give patients greater access to lower-cost sites of care.
For years, North Carolina’s CON laws have limited the ability of new providers to enter the market by requiring state approval before certain healthcare facilities can open or expand. The outdated system has served to protect entrenched hospital system interests while driving up costs for consumers, employers, and taxpayers.
Lee’s legislation directly addresses those concerns.
During committee debate, Lee highlighted research from the American Academy of Orthopedic Surgeons showing procedures performed at ambulatory surgical centers resulted in “approximately 35 percent savings at total costs, 41 percent savings in facility fees, 36 percent savings in Medicare payments, and 28 percent savings in patient payments compared with hospital outpatient or inpatient settings.”
“If we want to talk about costs and talk about saving dollars, this is a meaningful step that we can do to actually make that happen,” Lee told the committee.
The legislation comes as healthcare affordability continues to dominate conversations among North Carolina families, employers, and policymakers. Hospital prices remain one of the largest drivers of rising healthcare costs, and allowing more procedures to move into independent surgical centers would create meaningful downward pressure on spending.
“This is something meaningful that we can do to save taxpayer dollars, to drive down health insurance premiums,” Lee said.
Predictably, the hospital lobby is opposing CON reform efforts, arguing the state should move cautiously before pursuing additional changes to the healthcare marketplace.
That opposition was met with sharp criticism from Senators.
“It’s a Soviet-style practice of controlling supply,” Sen. Amy Galey said. “And as the Soviet Union has fallen, I think CON should fall. We should tear down that wall.”
Lee also pushed back, pointing to other states that have already successfully modernized their CON laws.
“Other states have done this. It’s not hard,” Lee said. “We just need to have the political courage and the will to make it happen, and I think we can do it.”
North Carolina has already taken steps toward CON reform in recent years. Senate Bill 1040 builds on that momentum and represents another practical, pro-consumer reform focused on affordability.
For patients facing rising premiums, growing deductibles, and higher out-of-pocket costs, the bill represents a straightforward principle: more competition, more choice, and lower-cost care options for North Carolinians.
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