One of the most significant aspects of P.L. 93-641, the National Health Planning and Resources Development Act of 1974 is the requirement that States adopt certificate of need laws as a method of health facilities regulation. This demonstrates a certain Congressional dissatisfaction with health planning alone and a desire to be more active in the actual distribution of health care facilities.

Over the years Congress has made a number of attempts to institute federal programs that would insure an adequate supply of health services to all people In 1946 it passed the Hill-Burton Act which was designed to respond to Congress perception that an inadequate supply of hospital beds existed in the United Slates. In addition to providing funds for the actual building of hospital beds, Hill-Burton required states to conduct surveys of bedding patterns and to participate in some rudimentary planning.