Certificate-of-need (CON) laws require healthcare providers to obtain permission before they open or expand their services or purchase certain devices or new technologies. CON applicants must prove that the community needs the new or expanded service, and existing providers are invited to challenge would-be competitors’ applications. CON laws have persisted in spite of mounting evidence from health economists, regulatory economists, and antitrust lawyers showing that these laws fail to achieve their intended goals. The charts in this profile are based on studies comparing outcomes in states that have CON laws with outcomes in those that do not. These comparisons account for socioeconomic differences and differences in the underlying health of the populations across states. The studies highlighted in this profile give some insight into what is likely to happen in a hypothetical West Virginia without CON laws.