Preventive care or healthcare innovation legislation promising decadeslong savings benefits may soon get fairer appraisals from Congress’ nonpartisan scorekeeper.
Tuesday, the House of Representatives passed a bill that would allow lawmakers to request the Congressional Budget Office (CBO) to generate budgetary savings estimates of prospective preventive healthcare legislation over a 30-year window as opposed to the current 10-year scoring window.
The Dr. Michael C. Burgess Preventive Health Savings Act (PHSA; H.R. 766), which was introduced by Reps. Michael Burgess, M.D. R-Texas, and Diana DeGette, D-Colorado, passed through the chamber by a bipartisan voice vote under suspension of the rules.
DeGette and other supporters of the bill said the longer window removes a major barrier to preventive care programs and investments by more “accurately gauging long-term savings.” They also pointed to the country’s substantial spending on healthcare as evidence of the bill’s necessity.
“With chronic diseases accounting for over 70% of health care spending, this bill will ensure the Congressional Budget Office has access to the necessary tools to calculate the long-term cost saving potentials of preventive health care initiatives,” Burgess said in a statement. “The passage of this bill lays the foundation for future policies that will reduce chronic disease illnesses, manage risks before they become detrimental to the patients’ health, and lower health care costs for Americans.”
Burgess has been pursuing iterations of the legislation since 2012. The House Committee on the Budget amended the bill to include his name when advancing the bill last month in recognition of Burgess’ upcoming retirement.
Rep. Jodey Arrington, R-Texas, chairman of the House Committee on the Budget, said in a statement that PHSA is primed to correct CBO’s “antiquated process” for calculating healthcare legislation cost estimates.
The passage was celebrated by the Healthcare Leadership Council, which said it has supported and contributed to the legislation’s makeup since 2012. The group echoed lawmakers’ warnings on rising chronic disease management spending and said PHSA will help realign investment incentives within the private sector toward wellness, nutrition and physical activity incentives.
“The American healthcare system continues to advance towards a value-based system where the outcomes realized are prioritized over the volume of services rendered,” Maria Ghazal, president and CEO of the Healthcare Leadership Council, said in a statement. “At the core of this evolution is and must be a realization that maintaining and advancing wellness rather than managing illness is a solution to lowering costs. However, the fiscal savings in both patient health and the overall cost of care must be recognized as legislation advances this continued transformation.”
Senate Majority Leader Chuck Schumer, D-New York, has not signaled whether he will bring the bill to a vote in the upper house.
The scores and estimates CBO prepares for lawmakers play a substantial role during deliberations over a bill’s passage.
However, health spend forecasting has proven to be a difficult task. In a report released last year, the office acknowledged that its 2010 projection of $11.7 trillion of mandatory healthcare spending across the coming decade overshot reality by about $1.1 trillion. The error, CBO told Congress, was largely due to lower-than-anticipated spending for Medicare Part D prescription drugs and long-term services and supports in Medicaid.
CBO wrote in that report that assessing estimates of legislation “can be challenging for various reasons,” such as the difficulty of isolating the specific effects of legislation from other underlying changes within administrative data sets.