1. United States
2. N.C.
3. Letter

As your constituent, and a voter concerned about healthcare in rural North Carolina, I write to urge you to oppose SB1040 and any companion legislation that would narrow or eliminate certificate-of-need (CON) review requirements for certain hospitals or capital projects, raise the project-size thresholds that trigger review, or exempt transactions from review when purchasers are large health systems or private equity buyers. These proposed changes would tilt the health care market heavily in favor of large corporate buyers and pose serious risks to rural hospital stability and community health. CON review exists to protect access to care, prevent unnecessary duplication of services, preserve financial viability of community hospitals, and limit market consolidation that drives up costs and reduces choice. Weakening or eliminating CON protections would make it easier for well-capitalized purchasers to acquire or close rural facilities, strip essential services, or repurpose assets in ways that harm patients and local economies. Rural communities face unique workforce, transportation, and economic challenges that make their hospitals and clinics fragile. Unchecked consolidation and exemptions for large buyers often result in facility closures, reduced emergency and maternity services, longer patient travel times, and loss of local jobs. This undermines the health and economic resilience of entire regions. Instead of rolling back CON safeguards, I urge you to fully fund and expand the Rural Health Transformation Project. This program is a proven, forward-looking investment that supports: Regional rural healthcare hub development to strengthen coordinated care across communities Workforce development initiatives to recruit and retain clinicians in rural areas Primary care and maternal health services critical to community health and equity Behavioral health capacity building to address rising mental health and substance use needs Telehealth expansion to connect patients with specialty care and reduce travel burdens Investing in the Rural Health Transformation Project is a fiscally responsible approach that supports sustainable, locally responsive health systems and reduces the need for reactive market consolidations. Fully funding this initiative will help stabilize rural hospitals, preserve essential services, and improve health outcomes for North Carolinians across the state. Please oppose SB1040 and similar measures that weaken CON review, and allocate full funding to the Rural Health Transformation Project to protect and strengthen rural health care access. Thank you for your attention to this urgent matter.