Certificate of Need (CON) laws require doctors and hospitals to get special permission from the state to open or expand their facilities and service lines, and sometimes even to renew their leases. Incumbent health systems use these laws to limit the entry of new, competing medical facilities and technologies. Each row in the dataset corresponds to a single state. If a state’s certificate-of-need law was in effect for six months or more that year, the corresponding cell is shaded. To capture the full legislative timeline (including a brief federal CON mandate later struck down by SCOTUS), the dataset also includes three dated fields to show when CON was first enacted, repealed, and reinstated (if applicable). All dates were drawn from state legislative archives (LexisNexis, HeinOnline), and a notes column flags any additional state-specific details.
