The former Speaker of the House in the South Carolina legislature, Jay Lucas, left his role about a month ago. Now, he’s been named the top lobbyist for the state’s largest hospital corporation, Prisma Health.
That’s sus. Here’s why.
This year, South Carolina came within inches of passing one of the most important healthcare reforms on the table: a full repeal of certificate of need laws.
Certificate of need laws, more commonly referred to by their (highly appropriate) acronym—CON laws—are some of the most corrupt on the books. These laws were largely put in place during the 1970s, with the direct intention of limiting the supply of healthcare services.
Why would someone want to do that? Pretty simple. When you limit the supply of healthcare, service providers can charge more.
Major healthcare corporations love these laws, and they spend a lot of money on lobbying to keep them—as was the case in South Carolina this year. Under CON laws, people who want to build a new hospital, add new healthcare technology, or even just expand the number of beds in their company for treatment must go before a regulatory board and argue why they need this expansion. Their (typically much larger and better funded) competitors then get to come in and argue against them.
And guess who staffs these regulatory boards? Usually, people who are pretty highly connected to politicians and major healthcare corporations. Long story short, the smaller competitors are often blocked from offering new services.
You get the scheme now, right?
These laws are not only one major reason why healthcare costs have skyrocketed in recent decades—they also have deadly consequences.
For good reason, therefore, many in South Carolina worked to eradicate this rot from their system over the past year. The governor came out in favor of the reform and, according to sources on the ground, the votes were there. But in the eleventh hour, the bill was killed (somewhat suspiciously by a former supporter) on a procedural move.
What’s all this have to do with Jay Lucas and Prisma Health?
Well, Prisma Health is so large and dominant in the state of South Carolina it has been called a monopoly by some, and it unquestionably benefits from the presence of CON laws immensely in order to maintain that position in the market. According to sources on the ground, the company worked diligently to kill the repeal of CON in 2022, making its immediate hire of the now former speaker of the house suspect, to say the least.
“If CON is repealed, it would challenge the ability of not-for-profit, safety net health systems like Prisma Health – which operates in urban, suburban and rural communities – to provide health care to everyone who needs it, whether or not they have the ability to pay for it,” said Mark O’Halla, president and chief executive officer of Prisma, earlier this year.
These are the kinds of disingenuous arguments often employed by supporters of CON (they can’t very well come out and tell you the real reasons they want the system to stay in place, now can they?). But they’re false. CON laws work to prevent the expansion of healthcare facilities in more communities so that the existing large corporations will have less competition.
This is exactly the kind of political corruption Americans have had enough of. We know things are broken. We know politicians are in bed with crony companies and rigging the game against us. We just don’t always know exactly how the sausage gets made behind the scenes. But regardless of what deals were or were not made in this situation, one thing is certain: the company is on the defensive for a future CON repeal push.
And they’ve now got a very well-connected former politician as their top lobbyist who may well be assisting that effort. That’s a lot for advocates on the ground to overcome, as former speakers carry an immense amount of sway with other lawmakers.
Still, given just how bad and corrupt CON laws are, and how close the state came to full repeal this year, perhaps we can take Prisma’s hire as an indication they know they’re losing this battle in the long run.
(Disclosure: Hannah Cox is a media consultant for Americans for Prosperity, an organization that works on certificate of need laws reform).