Thanks to overwhelming public support across the Volunteer State, the Tennessee General Assembly is preparing to vote on important "Certificate of Need" (CON) reform legislation on the House floor that would repeal CON requirements for acute care hospitals and other critical services. 

Tennessee legislators and community leaders have called for reforming these harmful laws to increase access to affordable, high-quality care across Tennessee. 

Governor Bill Lee (R-TN) Stressed the Need to Repeal Tennessee’s CON Laws This Session in His 2026 State of the State Address:

“But right now, if a doctor wants to open a new clinic in a rural county or if your hospital wants to build an imaging center closer to families that need it, existing Certificate of Need laws make it nearly impossible. 

“These laws were created over 50 years ago to prevent hospital overbuilding, but today, what they do is block investment, limit competition, and leave rural communities with few or even zero choices. Since 2000, Certificate of Need laws have turned away nearly $1.5 billion in healthcare investment in our state. Those are clinics that were never built, beds that were never added, care that never came.

“States like Texas and Florida got government out of the way, and as a result, their rural communities have more hospitals, more surgery centers, and more options for care for their people. This General Assembly began reforming these laws years ago. We should finish the job for rural Tennessee, and the time is now.” (Tennessee State of the State Address, Governor Bill Lee, 2/2/26)

U.S. Senator Marsha Blackburn (R-TN) Called on the General Assembly to Pass the CON Reform Legislation That is Set to be Voted On by the Tennessee House this Session:

“HB819, sponsored by [Johnny Garrett], cuts red tape and expands healthcare access for families across Tennessee, especially in rural counties. This is what Conservative leadership looks like, and I urge you to join me in supporting this commonsense legislation. #StoptheCON” (Post on X, Senator Marsha Blackburn, 4/7/26) 

Tennessee Speaker of the House Cameron Sexton (R-Crossville) Noted CON Laws Continue to be a Government-Imposed Barrier to Competition and Healthcare Access:

“In rural healthcare, we're looking at CON reform that we've done for years to limit the barriers, provide more access, to allow more opportunities for health care providers [and] health care facilities to move into those areas, to offer services, [and] not have government be a barrier to that access.” (Take Back Your Health Event, Speaker Cameron Sexton, 2/5/26)

Tennessee House Majority Leader William Lamberth Said Eliminating CON Requirements Will Reduce Wait Times and Expand Healthcare Access Across the State:

“Doing away with Certificate of Need, which is something we've been dealing with for years, will drop wait times at hospitals. It will create more competition. It will create more medical assets within this entire state so that you have additional locations where folks can seek assistance.” (House GOP Press Conference, Leader William Lamberth, 3/5/26)

Tennessee House Republican Caucus Chairman Jeremy Faison Emphasized That Expanding Competition Will Improve Access to Care for Patients Across Tennessee:

“Legislatures in the past, not just in Tennessee but throughout America, have made decisions when it comes to health care based on insurance or based on health care systems themselves. We in Tennessee are realizing that's probably not the best model. Our best model should be access to Tennesseans.

“History has proven time and time again that a free market and competition drives success. It pushes success. You have to get leaner, you have to get smarter and you have to come toward the patients and say, ‘Hey, there's a reason you come to me.’ When you do that, you set up a system that all the people in Tennessee benefit from.

“I’ve actually had nonprofits come as recently as yesterday and say we are so excited about doing away with the CON because we feel like there's just been a market barrier.” (House GOP Press Conference, Caucus Chairman Jeremy Faison, 3/5/26)

Pacific Legal Foundation Policy Experts Emily Amin and Jaimie Cavanaugh Urged Tennessee Lawmakers to Finish the Job on CON Repeal in 2026:

“The evidence is clear: CON laws raise costs, reduce access and disproportionately affect rural residents. Repealing CON laws by 2027 is not just good policy; it’s an obligation to the communities this system has failed for so long.” (The Tennessean, Emily Amin and Jamie Cavanaugh, Pacific Legal Foundation, 1/16/26)

Senator Shane Reeves (R-Murfreesboro) Highlighted Previous Pro-Competition CON Reforms:

“In Tennessee, we’ve worked to streamline the Certificate of Need (CON) process, which regulates new healthcare facilities, to encourage competition and expand care access.” (“Trump’s Return to the Presidency Signals Good News for Tennessee Health Care,” Senator Shane Reeves, 12/14/24)

Policy Experts from The Beacon Center of Tennessee Praised 2021 CON Reforms and Called for Continued Action Ahead of the 2024 Session.:

“Tennessee’s outdated CON laws have left Tennesseans with fewer medical treatment options, including some areas of the state being consistently denied emergency facilities.” (“Eliminating Tennessee’s Health Care Permission Slips Will Make The State Healthier, Wealthier,” Ron Schultis and Amanda Hagerman, 2/20/2023)

“In fact, if we repealed all of Tennessee’s current hospital CON laws, there could be up to 63 more hospitals in the state, with 25 located in rural areas.” (“Eliminating Tennessee’s Health Care Permission Slips Will Make The State Healthier, Wealthier,” Ron Schultis and Amanda Hagerman, 2/20/2023)

Knox County Mayor Glenn Jacobs Praised the Governor and State Legislature for Passing Reforms in 2021 and Urged Continued Legislative Action:

“I am relieved that others share my grave concern about Tennessee’s CON laws. Gov. Bill Lee and the state legislature made substantial progress in reforming the flawed CON process last year, but more work remains to be done.” (“County Mayor: Repeal Certificate of Need Laws to Protect Health Care Freedom," Mayor Glenn Jacobs, 1/31/2023)

Dr. Ron Kirkland, Former Chair of The Jackson Clinic, Chair of the American Medical Group Association, and President of the Tennessee Medical Association, Praised Previous CON Reform Efforts in Tennessee and Urged State Lawmakers to Finish the Job:

“More choices also help ensure providers are better able to care for patients. Competition ensures providers are also constantly striving to improve the quality and affordability of care. Tennessee’s CON laws promote the opposite. They prevent new providers from opening hospitals and other facilities unless they first demonstrate a “need” for their services in the community ... Thankfully, we’ve made recent progress towards fully repealing Tennessee’s harmful CON laws.” (“Repealing Outmoded Law Could Benefit Patients, Providers, Community,” Dr. Ron Kirkland, 2/28/25)

A Coalition Letter Signed by Patients, Healthcare Providers and Taxpayer Groups Advocated for CON Reform to Increase Competition and Access to Care:

“We strongly believe Tennessee’s remaining Certificate of Need (CON) laws continue to significantly slow the necessary expansion of healthcare services across the state – limiting access to affordable, high-quality care, including by preventing the building of new hospitals in communities that need them.” (“Coalition Letter Calls for Full Repeal of Tennessee’s Remaining Certificate of Need Laws This Legislative Session,” 3/11/25)

Representative David Hawk Voiced Support for Efforts to Reform CON Laws:

“I believe that [CON] laws harm Tennesseans by limiting access to care and options for patients across our state. I will continue to be a voice in favor of repealing or at least reforming these laws, so that patients across our state have greater access to the health care they need.” (“Better Solutions Needed for Northeast Tennessee Health Care,” Rep. David Hawk, 1/24/25)

Tennessee Health Facilities Commissioner Logan Grant Described How CON Laws Restrict Competition:

“I would say that this is about making sure that if we're going to the extent that we have regulations in place to protect patients and markets…they should only exist to the point that they are directly improving the competition, improving the quality of those services and improving access.” (House Health Subcommittee, Commissioner Logan Grant, 4/6/21)

Public Interest Groups, Taxpayer Organizations and Local Tennessee Groups Echoed Support from U.S. Senator Marsha Blackburn Urging the General Assembly to Pass Critical CON Reform Legislation this Session:

Taxpayers Protection Alliance (TPA):

“CON repeal means more choice and lower costs for patients.” (Post on X, TPA, (4/8/26)

Consumer Action for a Stronger Economy (CASE):

“Curtailing anti-competitive policies like Certificates of Need is exactly the kind of reform that will reduce healthcare costs.” (Post on X, CASE, 4/8/26)

Latinos for TN:

“Thanks [Marsha Blackburn] & [Johnny Garrett] for supporting repealing certificates of need. Barriers to entry should be removed. Let the free market work and let more competition into the healthcare market. This will help patient access. #STOPtheCON” (Post on X, Latinos for TN, 4/9/26)

Legacy Society of Tennessee:

“Thanks to [Johnny Garrett] for reforming healthcare and putting patients first. CON laws are anti-free market. Appreciate [Marsha Blackburn] for her continued leadership on healthcare reform and putting free market principles first. #STOPtheCON” (Post on X, Legacy Society of Tennessee, 4/9/26)

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