Six U.S. states consider cutting hospital regulations for federal funds

Six U.S. states—Tennessee, Alaska, Connecticut, Delaware, Iowa, and Mississippi—are considering revising or ending their Certificate of Need (CON) laws following federal incentives from the Trump administration. CON laws currently require hospitals to obtain approval from health planning agencies before expanding or establishing new facilities, a process intended for cost control.

Under the One Big Beautiful Bill Act (OBBBA), the Centers for Medicare & Medicaid Services (CMS) has launched the $50 billion Rural Health Transformation Program. This initiative will distribute $10 billion annually from 2026 through 2030. The program uses a scoring system to allocate funds, where states with less restrictive CON policies receive higher scores.

While all 50 states were approved for the first year of funding, the additional allocations are tied to various factors, including workforce policy, emergency services, and technology. White House officials have described the program as a major investment intended to transform rural health access and meet the unique needs of these communities.