Wisconsin: A Mostly Free Market
Wisconsin repealed most of its CON program in 1987, retaining only a narrow moratorium on nursing home beds. This minimal regulation earns it a high score for market freedom.
Score Card
National Rank & Grade
Tier: Mostly Free
Governor
Tony Evers (D)
Key Barrier
Nursing Home Bed Moratorium
Regulated Services
1
Market Freedom
95%
What CON Covers in Wisconsin
Regulation is exclusively focused on long-term care facilities, leaving the broader healthcare market competitive.
Regulated Services
Wisconsin's CON program is a narrow exception in an otherwise free market. The only service requiring approval is the establishment of or increase in beds for nursing homes and certain long-term care facilities.
| Service | CON Required |
|---|---|
| Nursing Home Beds | Yes |
| Hospitals | No |
| Ambulatory Surgery Centers (ASCs) | No |
| MRI & CT Scanners | No |
| Most Other Services | No |
Application Process
The process is administered by the Wisconsin Department of Health Services under the Nursing Home Bed Moratorium (Wis. Stat. 150.31).
- Governing Body: Wisconsin Department of Health Services
- Key Statute: Wis. Stat. 150.31
- Application Fee: Varies
- Review Cycle: Batched reviews
- Incumbent Advantage: High, as moratoriums inherently protect existing providers.
Who Benefits from the Status Quo
While most of the market is competitive, the nursing home sector is controlled by established players.
Dominant Systems
The broader hospital and outpatient market is competitive, featuring several large non-profit systems. These systems compete on price and quality, unhindered by CON for most services. Major players include:
Advocate Health
(Formerly Advocate Aurora)
Ascension Wisconsin
Part of national system
Marshfield Clinic
Major regional system
The Human Cost of Limited Access
The nursing home moratorium can lead to restricted access and fewer choices for seniors, particularly in growing communities.
"By limiting the supply of nursing home beds, the state inadvertently inflates the value of existing licenses and creates barriers for new, potentially more innovative providers. This can result in older facilities, less competition on quality, and fewer options for families in need."
— A healthcare policy analyst
Reform Status: A Tale of Repeal
Pre-1987: Comprehensive CON
Like many states, Wisconsin had a broad CON program covering a wide range of healthcare services. This system was criticized for stifling competition and innovation.
Post-1987: Repeal & Moratorium
In a significant move towards deregulation, Wisconsin repealed most of its CON laws. However, political pressure led to the retention of the moratorium on new nursing home beds, preserving a pocket of protectionism.
The Rojas Report Take
Wisconsin stands as a testament to the benefits of market-based healthcare reform. The 1987 repeal unleashed competition, leading to a vibrant landscape of providers for most medical needs. The state serves as a powerful case study against the argument that CON is necessary to control costs or ensure quality. However, the lingering nursing home moratorium is a blemish on an otherwise exemplary record. It is a relic of a bygone era of central planning that harms the state's most vulnerable seniors by limiting their choices. The final step for Wisconsin is to eliminate this last vestige of CON and fully embrace a free market in all aspects of healthcare.