I am a Star Trek nerd through and through, ever since I can remember. Naturally, I’m a fan of “Star Trek II: The Wrath of Khan.”

I have many favorite scenes from that movie. I even have a Hallmark ornament of the (spoilers) famous engine room death scene with Adm. James T. Kirk and a mortally wounded Capt. Spock, separated by glass, unable to touch his dying first officer and friend.

But one of my all-time favorite scenes is Khan appearing to outwit Kirk, stealing the Genesis device and leaving him, his ex-lover, their son and his landing party marooned in the center of a dead planet, buried alive. After being goaded by Khan over the subspace radio, Kirk lets out a scream – “KHAN!”

I’m just imagining Gov. Patrick Morrisey screaming “CON!” I’m talking about the 12-13 vote last week in the House Health and Human Resources Committee, defeating an effort to recommend House Bill 2007, repealing the certificate of need program, to the full House of Delegates.

Not only did the committee vote down the bill, but when a motion to reconsider the vote later that evening was rejected. According to House rules, a motion to reconsider the vote on a bill can only be made once, so that effectively ensured no further consideration of that particular bill in that committee.

You can read many of my articles over the years for an in-depth explanation of what the CON program is, but in short, many healthcare services are required to apply for a certificate of need from the state, which can approve or reject it based on many factors, such as the availability of similar services in the region.

Thirty-five states have similar CON laws and only 12 states have repealed their CON programs. West Virginia’s CON program has been in place for nearly 50 years. At the time, CON laws were put in place to control health care costs and prohibit duplicative or unneeded medical services in communities.

The Legislature has tweaked the CON program several times over the years, providing exemptions for some services with high demand, such as birthing centers (though I’ve yet to see a plethora of new birthing center options across the state). Lawmakers have also put in place moratoriums on other services, such as limiting the number of methadone clinics in a state with an opioid crisis.

But at least twice now since I’ve been back reporting under the Golden Dome, there have been attempts to repeal the entire CON program. An attempt two years ago died in committee, and an attempt last year managed to get out of committee only to be parked on the House of Delegates inactive calendar for the remainder of the 2024 session.

But as we talked about two weeks ago in my column, there is a full-court press this year from Morrisey, the West Virginia chapter of Americans for Prosperity, the Cardinal Institute for West Virginia Policy and national conservative groups to pressure Republican lawmakers to repeal CON.

I’ll reveal a bias: I personally don’t have an immediate issue with repealing certificate of need. I’m a free-market guy and I get the arguments for ending it, but I also fully understand the point of view of the West Virginia Hospital Association. I find compelling arguments from both sides for and against.

Honestly, I see the biggest effect of ending CON being increased competition between in-state hospitals along our borders with hospital systems in neighboring states. And considering the payer mix in West Virginia being heavily subsidized by Medicare, Medicaid and public employees through PEIA (nearly 75% of the state’s healthcare payer mix), I think the only money to be made in West Virginia would be along the borders.

Considering our rankings in health (almost always poor), the age of our population, and much of our population receiving healthcare coverage from programs with low reimbursement rates limiting the profit that can be made here, I just don’t see CON repeal doing anything to coax new providers into parts of the state with the most need. The conservative think tanks don’t appear to be thinking about how to encourage healthcare providers to come to the parts of the state that could use more options.

While I get the position of the hospitals and the free market think tanks, what I can’t figure out is why the Gov. Morrisey decided to put so much pressure on lawmakers to make CON repeal the first bill he wants on his desk. What is the urgency?

I’ve already told you in a previous column that representatives of the governor’s office have threatened Republican lawmakers with primaries if they don’t line up behind CON repeal. One committee chair was yelled at for not making CON repeal the first bill to be taken up in their committee.

Phone calls were made over weekend before the House Health Committee vote and during the meeting trying to whip votes in the House Health Committee, with one delegate being brought to tears over it. I’ve even been told that First Lady Denise Morrisey has been involved in the lobbying effort.

So again, I ask why all the pressure and why all the urgency? It’s sowing a bunch of ill will from lawmakers toward the governor’s office and is poisoning the well for other priorities Morrisey would like to see passed. And while there are 41 days left in this 60-day session, time may be running out to make amends.

Speaking with Morrisey Friday, I think they are retooling their approach and working on another push for CON repeal in the coming weeks. Morrisey, much like Kirk in “The Wrath of Khan,” doesn’t like to lose. But if the governor’s office doesn’t change its approach, it may be too little too late.