The federal Rural Health Transformation Program grants are designed to improve rural healthcare access. Delaware’s plan focuses on a new medical school. While this is well and good in the long run, the state committed to a policy that would improve healthcare access, cost and quality much sooner and at no taxpayer cost, as a condition of the grant: eliminating or reforming the Certificate of Public Review program.

Under the CPR law, applicants must establish there is a need for additional healthcare capacity before a certificate is granted to build it. This requirement was based on the mistaken idea that excess capacity raises prices. Instead, this program has proven to be a barrier to new entrants, thus protecting existing healthcare suppliers from competition. Reduced competition leads to less access, higher costs and potentially lower-quality care.

The CPR application process is burdensome and risky. Although only two applications out of 28 were denied (2014-20), there is no data on deterred applications. Delays are common, thus substantially increasing costs. 

We at the Caesar Rodney Institute have heard from healthcare providers, “We don’t want to come to Delaware because of the CPR law. It isn’t worth the investment to risk approval.” The chilling effect of the CPR program on new entrants is very real. It is likely the program's greatest cost. But it leaves no data because those providers never applied. 

The Delaware legislature stated: Delaware commits to eliminating or loosening Certificate of Need laws (known as Certificate of Public Review in Delaware) to reduce regulatory barriers for providers establishing new facilities in rural areas.

CRI supports full repeal of Delaware's CPR law, as proposed in House Bill 318, which is currently stuck in committee. 

Delaware’s citizens are suffering from a lack of healthcare access now. Eliminating the CPR requirement is the action most likely to expand healthcare access and lower costs now, when we need it most. It costs taxpayers nothing. Delaware should eliminate the Certificate of Public Review law as soon as possible.