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Eleven states have removed all CON laws or caps: California, Colorado, Idaho, Kansas, New Hampshire, North Dakota, Pennsylvania, South Dakota, Texas, Utah, and Wyoming.
Certificates of need are necessary for the construction of medical facilities in 35 states and are issued by state health care agencies: The certificate-of-need requirement was originally based on state law.
State Laws and U.S. Constitution Because of the Supremacy Clause, state laws cannot supersede the constitutional rights afforded all U.S. citizens under federal law. No state law can abolish or reduce the rights afforded by the U.S. Constitution.
Texas repealed its Certificate of Need law in 1985. In the ten years following CON repeal, a total of 55 rural Texas hospitals closed. ing to the UNC demography department, North Carolina is the most rural state after Texas.
Florida requires CONs within three broad categoriesbeds outside hospitals, facilities and services. In 2019, Florida passed sweeping CON law reforms and eliminated many of its CON requirements. Post-reform, Florida maintains 11 CON requirements.
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Here are the states with no certificate-of-need laws: Arizona. California. Colorado. Idaho. Kansas. Minnesota. New Hampshire. New Mexico.

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