A virtual town hall with Sen. Krawiec, sponsored by Koch

Sen. Joyce Krawiec speaks to an anti-abortion rally in Winston-Salem in 2017. (file photo)

Sen. Joyce Krawiec, a Republican lawmaker from Forsyth County, told a conservative group during a Zoom conference call on Friday that she wants North Carolina to repeal its certificate of need law, which requires hospitals and other healthcare providers to obtain permission from the state before expanding with new facilities and equipment.

“It only benefits the people who are already in business, already providing, and that want to keep their competition out — simple as that,” Krawiec said during the “town hall” hosted by Americans For Prosperity and joined by 31 participants. Americans for Prosperity is backed by Charles Koch, the libertarian billionaire owner of Koch Industries.

Repealing the certificate of need law is also a priority of Americans For Prosperity.

“It’s going to improve the amount of quality healthcare we’re getting,” said Tyler Voigt, the deputy state director. “It’s going to increase competition. It’s going to lower prices.”

The state Healthcare Planning and Certificate of Need Section recently awarded a certificate of need to a subsidiary of Baptist Hospital to operate a new MRI scanner in Forsyth County, setting aside a competing application from a partnership that included rival Novant Health.

Dr. Gajendra Singh, who operates the Forsyth Imaging Center, is suing the state to overturn the certificate of need law, arguing that the law drives up costs for consumers, accomplishing exactly the opposite of its intent. Singh’s practice utilized an X-ray machine and computerized tomography. He rented a mobile MRI scanner, characterized by the nonprofit litigating the case as “an enormous cost.” To comply with the state law limiting the number of fixed MRI scanners in operation, Singh was required to move his mobile MRI scanner at least once a week, preventing him from providing reliable access to his patients. Singh contended that if he were able to purchase a fixed MRI scanner, it would have put his business “on much sturdier financial ground and reduce its operating overhead.”

A staffer who answered the phone at Forsyth Imaging Center on Friday said the facility “has gone out of business.”

“When this pandemic hit, Dr. Singh decided to close his practice,” Krawiec said. “He said he just can’t make it any longer. So, that lawsuit is gone.” Krawiec added that the Institute for Justice, which has been representing Singh, is looking for a new plaintiff to continue the legal challenge. The lawsuit is currently described as “open” on the nonprofit’s website. A listed media representative did not respond to a query on the case’s status before publication of this story.

A 2017 report by the Mercatus Center indicates that states with certificate of need laws have fewer hospitals, and particularly fewer rural hospitals. The same report found higher rates of death from treatable complications following surgery and higher mortality rates from heart failure and pneumonia, while also finding that certificate of need regulations increase per-unit healthcare costs by limiting supply.

In early April, Gov. Roy Cooper issued an executive order streamlining regulations on healthcare facilities and equipment. The order gives the state Division of Health Service Regulation the authority to allow for the relocation of hospital beds, addition of dialysis stations, acquisition of medical imaging equipment and ambulatory surgical facilities to operate as temporary hospitals without obtaining a certificate of need. But the executive order stipulates that the suspension of the regulations will only last for the duration of the state of emergency, and that all equipment acquired during the pandemic must be returned no later than 30 days following after the state of emergency is lifted.

“That’s an admission to me that certificate of need is a hindrance to care,” Krawiec said. “So, I think they admitted it by taking that step, even though it was temporary and only during the pandemic. But good policy is good policy, whether there’s a pandemic, or whether it’s just in our everyday healthcare needs.”

During the town hall, Krawiec suggested that Gov. Cooper, a Democrat, is the chief impediment to repealing the certificate of need law. An ardent foe of abortion, Krawiec joked that “half of the bills” the governor “vetoed last summer were mine.

“We have this really close relationship,” she said with obvious sarcasm, adding, “but we have to have some bipartisan support. It’s very difficult to do in this political climate.”

But SB 646, the reform bill Krawiec filed in February 2019, hasn’t gotten anywhere near the governor’s desk. The bill has been stalled in the Rules Committee, which is chaired by Krawiec’s Republican colleague, Sen. Bill Rabon of Brunswick County.