Hospital Denied Again: Why Raleigh Bureaucrats Are Gambling with Wake Forest Lives

If you drove down Capital Boulevard this morning, you sat in it. The gridlock. The red lights. The absolute nightmare that is our daily commute. Now, imagine doing that drive while having a heart attack. Imagine doing it while your child is struggling to breathe in the backseat.

That is the reality for Wake Forest, Youngsville, and Franklin County residents. And as of January 28, 2026, the state of North Carolina has decided—for the second time in two years—that this reality is perfectly acceptable.

The Department of Health and Human Services (DHHS) has officially denied UNC Health Rex’s application to build a hospital right here in Wake Forest. Again.

Let’s cut through the jargon. We aren’t being denied a hospital because we don’t need one.

• The State Admitted the Need: The 2025 State Medical Facilities Plan explicitly stated Wake County needed 267 new hospital beds. That is a historic number.

• We Have the Land: The Seminary (SEBTS) is ready to sell the land behind the Crossing.

• We Have the Money: UNC Health is ready to spend $485.5 million to build the infrastructure we need.

So why did they say no?

Bureaucracy. Red Tape. And the Certificate of Need (CON) Law.

The regulators in Raleigh looked at the application and essentially decided that it is “cost-effective” to add beds to existing hospitals in Raleigh and Cary rather than build a new one in Wake Forest. They are prioritizing the profit margins of existing “flagship” campuses over the desperate need for infrastructure in the fastest-growing corner of the state.

North Carolina isn’t just “restrictive”; we are a national outlier. According to research from the Mercatus Center, North Carolina has the second-highest number of CON restrictions in the entire United States.

While 11 states have removed these laws entirely, North Carolina maintains 27 different restrictions that require providers to “seek permission” before offering new services. The Mercatus data exposes the human cost of this gatekeeping:

• Higher Mortality Rates: In CON states, mortality rates for heart attacks, heart failure, and pneumonia are 2.5% to 5% higher than in states without these laws.

• Fewer Options: CON laws are associated with 30% fewer hospitals per capita and significantly fewer rural facilities.

• Artificial Scarcity: These laws reduce the number of hospital beds by an average of 99 beds per 100,000 people.

In short: WakeMed North and the Raleigh “flagships” get the beds, while Wake Forest gets nothing but more traffic and a 40-minute ambulance ride to hope for the best.

The Certificate of Need (CON) law is a relic. The federal government repealed its version of it in 1987, and many other states have followed suit. Here in NC, it allows existing hospital systems to essentially veto their competition. It creates a “Mother May I?” system where we have to beg Raleigh for permission to invest in healthcare infrastructure.

The result?

1. WakeMed North gets to claim they serve us (even though they are effectively in Raleigh).

2. Raleigh and Cary get hundreds of new beds (approved last month).

3. Wake Forest gets nothing but more traffic and a 30-minute ambulance ride to help.

Let’s be clear: We have the vision, the leadership, and the will to get this done. The only thing standing in our way is a broken state law.

We are currently watching a game of ping-pong. UNC Rex is likely in the process of filing a going to appeal of this decision (again). We are looking at lawyers arguing in a windowless room while our population continues to explode.

We cannot wait for the lawyers. We need a legislative fix.

Senate Bill 370 is sitting in the legislature right now. It is the “Big Repeal” that would kill the CON laws and allow hospitals to be built where they are needed, not where bureaucrats say they fit on a spreadsheet.

• It passed the Senate.

• It is currently stalled in the House, blocked by lobbyists from the NCHA (the hospital association) who want to protect their monopolies.

What You Can Do

1. Call your State House Representative: Tell them to move Senate Bill 370.

2. Share this post: The only way we beat the lobbyists in Raleigh is if the noise from Wake Forest becomes too loud to ignore.

Subscribe to Wake Forest Matters for updates on the UNC Rex appeal and the status of Senate Bill 370.

Tom Baker IV

Tom Baker IV is the publisher of Wake Forest Matters, Wake Forest’s only independent local newsroom. A Wake Forest native, Navy veteran, and intelligence professional, Tom launched Wake Forest Matters to bring serious accountability journalism to his hometown. Tips and story ideas: publisher@wakeforestmatters.com