The Paper will proceed in five parts. Part I will present the history of COPN, both nationally and in Virginia. Next, Part II will detail Virginia’s COPN program and its State Medical Facilities Plan. Part III will discuss the current debate for and against the COPN program. In Part IV, this Paper will discuss the market irregularities that the health care industry faces and how Virginia’s COPN program helps insulate hospitals from these market imbalances. Lastly, Part V will focus on the impact that the Medicaid expansion has on the COPN program, focusing particularly on the effects of the program’s charity care requirements. This Paper will conclude that Virginia’s COPN program should be reformed in light of Medicaid expansion, rather than repealed.

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2nd Place, Virginia State Bar Health Law Writing Competition