Charles “Butch” Slaughter is a Mississippi physical therapist who has worked for many decades. He has a special interest in foot and ankle injuries. Patients were cancelling their appointments during the pandemic to avoid being exposed to COVID-19. He made the decision to open a home-based health agency to take care of Jackson’s elderly population. Slaughter stated that people age more quickly and have a greater tendency to break their hips. They won’t be paying those huge bills if they can prevent it from happening in the first place. People can stay at home, and don’t need to be admitted to a nursing facility. People don’t want the hassle of going to a nursing home. But Slaughter quickly realized that there was much more to do before he could grow his business. The Mississippi Department of Health has been prohibited from issuing certificates of necessity (CON) to home-health agencies under a 40-year-old law. Slaughter would need to purchase one from an existing provider as there are only 50 CONs available for these providers in the state. He would be facing misdemeanor charges as well as a $500 daily fine if he opened a home-health agency without a CON. Even if there was no ban on new CONs, Slaughter could still be challenged by existing providers who might argue in court that a home health agency isn’t necessary. After the 1974 National Health Planning and Resources Development Act, which required states to establish CON programs in order to be eligible for federal funding, CON laws were common. It was believed that limiting the supply of health-care providers would reduce costs. Mississippi’s CON law was passed by the legislature in 1979. Although Congress repealed the federal CON legislation in 1987, Mississippi’s CON law is still in force. Aaron Rice, director at the Mississippi Justice Institute, and Slaughter’s lawyer, stated that these certificate of need laws were a remnant of an unsuccessful experiment by the federal government in controlling health care costs. Rice claims that although there are 50 home-health agency CONs, only a handful of providers actually use them. Many are subsidiaries of larger organizations. Slaughter sued the state health officials in federal court in December 2020. He argued that the ban on the issuing of new CONs and the general CON requirement for home-health agencies are unconstitutional. Although he did not rule on the constitutional issues, U.S. District Judge Carlton Reeves acknowledged that Slaughter had a valid argument when he denied the state’s motion for dismissal. Reeves stated that CON laws are a matter of significant financial interest. Numerous studies have proven that CON laws are not improving. One 2020 study found that CON laws have increased elderly mortality rates and health care costs. The Federal Trade Commission and U.S. Department of Justice jointly reported in 2016 that the laws “can hinder the efficient functioning of healthcare markets.” They also stated that they “limit consumer choice and stifle innovations.” Slaughter is excited to enter the discovery phase of the suit and will be presenting his arguments at trial. “This gives us hope and helps us solve this problem so that I can not only open a home-health agency, but also that others can. This is for the people in Mississippi.