Antitrust Liability for Licensing Boards After North Carolina Dental: Antitrust Preemption as a Penalty Default?


Most professions in the United States are regulated by boards composed of industry practitioners, who in their official roles routinely engage in anticompetitive conduct.  Until the Supreme Court’s landmark decision in North Carolina State Board of Dental Examiners v. FTC, many believed that such conduct was beyond the reach of antitrust enforcement as long as it was taken pursuant to state policy to displace competition—a standard met with relative ease.  After North Carolina Dental, states now must additionally take ownership of the anticompetitive actions of these boards to avoid the full force of the antitrust laws.  In this manner, North Carolina Dental has the potential to prompt a large-scale restructuring of the state regulatory apparatus.  This article explores the potential for antitrust preemption to play a role in this restructuring.  I argue that, to the extent that unsupervised boards’ anticompetitive conduct would be justified on non-competition concerns, they are rendered defenseless in any rule of reason inquiry, and hence are subject to a de facto per se standard.  Rather than adjusting the rule of reason inquiry to allow courts to weigh non-competition concerns in these cases, the better alternative would be to preempt the laws altogether.  This approach has several advantages.  First, it would avoid a dissonance between antitrust and due process inquiries into the same conduct.  Second, it would act as a penalty default for states, and like penalty defaults in contracts, such a rule would assign the regulatory decision to the low-cost information provider—the state, rather than the court.  Finally, this approach vindicates federalism to a greater extent than a modified rule of reason.  The only role for a federal court under a preemption approach would be to uphold or strike down the law granting the board authority to engage in the suspect conduct.  This decision, moreover, would be based on an objective analysis of the board’s regulatory structure, rather than a subjective weighing of competition and non-competition concerns.