Health care didn’t become expensive by accident. It became expensive in part because, for decades, government at every level has operated on the same false assumption: that control equals efficiency. The Affordable Care Act in Washington and Certificate of Need laws in Charleston are twin products of that same philosophy — and together, they’ve built the most expensive, least competitive health-care system in the industrialized world.
The Affordable Care Act (ACA) promised affordability through regulation. Instead, it nationalized the insurance market. By dictating what every plan must cover, what insurers can charge, and who must buy it, the ACA stripped competition out of the marketplace. Premiums didn’t fall — they skyrocketed. Small insurers disappeared. Networks shrank. Patients lost their doctors. In the name of fairness, Washington created uniformity — and uniformity killed innovation.
Meanwhile, on the supply side, Certificate of Need (CON) laws in states like West Virginia have done the same thing to hospitals and clinics that the ACA did to insurers. Before a new provider can open a surgical center or expand services, they must “prove need” to the state — and those determinations often rely on input from the very hospitals that don’t want competition. It’s the bureaucratic equivalent of asking McDonald’s to sign off on a permit for Burger King.
Both policies grew out of good intentions, but both share a fatal flaw: they assume bureaucrats, not markets, should decide what “enough” looks like. The ACA micromanaged demand. CON laws micromanaged supply. The result is predictable — higher prices, fewer choices, and a health-care system built to serve institutions, not individuals.
If we want affordable health care, we must restore competition on both ends of the system. That means allowing insurers to design diverse plans that fit different needs and budgets — not one-size-fits-all government templates. And it means repealing Certificate of Need laws so doctors, entrepreneurs, and communities can open clinics wherever patients need them most.
No more permission slips from bureaucrats. No more protectionism dressed up as “planning.”
It’s time to abolish both the ACA and CON — and let the free market heal what government broke.
Rocky Seay is the district general agent and cofounder of Colonial Appalachia, a premier health and supplemental insurance brokerage. He is seeking the Republican nomination for the state senate in district six.
