Dr. Michael C. Burgess Preventive Health Savings Act
Floor Speech
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Mr. BURGESS. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 766) to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows: H.R. 766 [Report No. 118-426] To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE.
This Act may be cited as the ``Dr. Michael C. Burgess Preventive Health Savings Act''. SEC. 2. SCORING OF PREVENTIVE HEALTH SAVINGS.
Section 202 of the Congressional Budget and Impoundment Control Act of 1974 (2 U.S.C. 602) is amended by adding at the end the following:
``(h) Scoring of Preventive Health Savings.--
``(1) Determination by the director.--Upon a request by the chairman and ranking minority member of the Committee on the Budget of the Senate and chairman and ranking minority member of the committee of primary jurisdiction of the Senate or by the chairman and ranking minority member of the Committee on the Budget of the House of Representatives and the chairman and ranking minority member of the committee of primary jurisdiction of the House of Representatives, the Director shall determine if proposed legislation would result in net reductions in budget outlays in budgetary outyears through the use of preventive health care.
``(2) Projections.--If the Director determines that proposed legislation would result in net reductions in budget outlays as described in paragraph (1), the Director--
``(A) shall include, in any projection prepared by the Director on such proposed legislation, a description and estimate of the reductions in budget outlays in the budgetary outyears and a description of the basis for such conclusions; and
``(B) may prepare a budget projection that includes some or all of the budgetary outyears, notwithstanding the time periods for projections described in subsection (e) and sections 308, 402, and 424.
``(3) Limitation.--Any estimate provided by the Director pursuant to paragraph (1) shall be used as a supplementary estimate and may not be used to determine compliance with the Congressional Budget Act of 1974 or any other budgetary enforcement controls.
``(4) Definitions.--As used in this subsection--
``(A) the term `budgetary outyears' means the 2 consecutive 10-year periods beginning with the first fiscal year that is 10 years after the current fiscal year; and
``(B) the term `preventive health care' means an action that focuses on the health of the public, individuals, and defined populations in order to protect, promote, and maintain health and wellness and prevent disease, disability, and premature death, including through the promotion and use of effective, innovative health care interventions that are demonstrated by credible and publicly available evidence from epidemiological projection models, clinical trials, observational studies in humans, longitudinal studies, and meta-analysis.''.
Mr. Speaker, I rise today in support of H.R. 766, the Dr. Michael C. Burgess Preventive Health Savings Act.
This pivotal piece of legislation seeks to establish a mechanism for the Congressional Budget Office to more accurately reflect the long- term, cost-saving potential of preventive healthcare initiatives.
This bipartisan, bicameral effort underscores our commitment to promoting the health and well-being of all Americans. We encourage the use of data-informed preventive health measures, and we are taking proactive steps toward not only saving lives, but also saving taxpayer dollars in the long run.
Chronic illnesses account for over 70 percent of all our healthcare spending, and they continue to pose a significant burden on our system and our economy.
However, by enacting measures like H.R. 766, we can begin to bend the cost curve and provide a more accurate understanding of the long-term cost savings from preventive healthcare policies.
H.R. 766 specifically allows the Congressional Budget Office, upon the instruction of Congress, to extend its analysis beyond the existing 10-year budget window to two additional 10-year periods. This provision will enable us to conduct a fuller analysis of the potential budgetary savings and the impact of preventive health legislation, ensuring that we make informed decisions based on sound evidence and data.
Moreover, the Dr. Michael C. Burgess Preventive Health Savings Act narrowly defines preventive health to encompass actions that focus on the health of the public, individuals, and defined populations.
By relying on credible and publicly available evidence from various sources, such as epidemiological projection models, clinical trials, and meta-analysis, we can ensure that our policies are both meaningful and impactful.
Lastly, H.R. 766 protects against estimates being used to justify partisan policies that might be used as budget gimmicks by requiring the request for a long-term estimate to be bipartisan and by stipulating such estimates cannot be used to comply with budget rules.
The successes of past legislation, such as the passage of Medicare part D in 2003, under a Republican majority in Congress, serves as a reminder of the profound impact preventive care can have on our healthcare. Despite initial concerns about its costs, Medicare part D has proven to be a wise investment, yielding savings and benefits that far outweigh its initial expenses.
In conclusion, I believe that an ounce of prevention is, indeed, worth a pound of cure, and preventive care in 2003 has yielded more than a pound of cure today. This undeniable truth underscores the case for preventive, personalized medicine and should only serve to encourage us to redouble our efforts and pass this important bill.
Mr. Speaker, I include in the Record a letter of support signed by 53 organizations as part of H.R. 766. March 4, 2024. Hon. Mike Johnson, Speaker, House of Representatives, Washington, DC. Hon. Hakeem Jeffries, Minority Leader, House of Representatives, Washington, DC.
Dear Speaker Johnson and Minority Leader Jeffries: We, the 53 undersigned organizations, would like to express our support for H.R. 766, the ``Dr. Michael C. Burgess Preventive Health Savings Act,'' which removes outdated statutory constraints which currently prevent Congressional Budget Office (CBO) estimates from correctly assessing preventive health initiatives that might achieve long-term health savings in federal programs.
As leaders in health care representing patients, providers, associations, and employers, we all agree on the need for a continued focus on wellness and disease prevention if healthcare costs are to be contained. We share a bipartisan, bicameral view with many in Congress that to move forward with policy solutions to address the growing burden of long- term chronic disease, Congress needs new tools to rise above traditional legislative approaches to health care.
Simply put, we know we can't ``cut'' our way to a healthier America by shaving dollars from federal programs that provide care to people in need every time Congress finds a new approach. As such, we all agree that the statutory constraints that CBO must currently follow to ``score'' legislation severely constrains the ability of policymakers to accurately assess legislation that would prevent chronic disease. We believe this legislation represents a significant step toward the goal of including new ideas and tactics to improve care that have proven successful in the private sector, or in health systems abroad that don't have the same regulatory or budgetary constraints.
Chronic disease places a significant burden on our health and economy, but it can be reversed:
We know that chronic diseases are responsible for 7 of 10 deaths among Americans each year, and they account for 90 percent of the $4.1 trillion our nation spends annually on medical care. These figures will worsen as the population ages.
Much of the illness, suffering, and early death related to chronic diseases is caused by modifiable health risk behaviors such as lack of physical activity, poor nutrition, tobacco use, and alcohol and substance misuse.
Preventing or delaying the onset of new cases and mitigating the progression of chronic disease will improve the health of people in America while lowering healthcare costs and overall spending.
The current scoring process does not give Congress a complete picture of efforts to combat chronic disease:
Research has demonstrated that certain expenditures for preventive health interventions generate savings when considered in the long term, but those cost savings may not be apparent when assessing only the first ten years--those in the ``scoring'' window.
Long-term benefits from current preventive health expenditures may not be fully reflected, if at all, in cost estimates from CBO.
Lawmakers need sound information, and today's methods and procedures may not work as well as needed in analyzing certain efforts to prevent costly complications of chronic diseases.
CBO has already begun to examine prevention in new ways:
In 2012, CBO published long-term estimates of the effect of a hypothetical tobacco tax on the federal budget.
Also, in 2012, CBO published a study which found greater prescription drug access and adherence can reduce healthcare costs in other areas.
In the 118th Congress, the House of Representatives continues to require CBO to score certain large bills by considering projected impacts on revenue and spending from assumed economic effects the bills.
The Preventive Health Savings Act will permit leaders in Congress to request that CBO estimate the long-term health savings that are possible from preventive health initiatives:
This legislation provides that the Chairman or Ranking member of either budget or health-related committees can request an analysis of the two 10-year periods beyond the existing 10-year window.
The bill requires CBO to conduct an initial analysis to determine whether the provision would result in substantial savings outside the normal scoring window.
CBO must include a description of those future-year savings in its budget projections but would retain the option of creating a formal projection that includes some or all the budgetary out years.
This bill is necessary to bring greater attention to the longer-term value of wellness and prevention policies specifically.
The bill defines preventive health as an action designed to avoid future healthcare costs that are demonstrated by credible and publicly available epidemiological projection models, incorporating clinical trials or observational studies in humans.
This narrow, responsible approach discourages abuse while encouraging a sensible review of health policies and programs Congress believes will further the public's health.
As the chronic disease epidemic continues to worsen, so does the need for legislation that will properly allow Congress to see the full savings of enacting prevention- focused policy measures.
We applaud your efforts in sponsoring this important legislation and look forward to joining with you in transforming our nation to one that prioritizes efforts to achieve wellness and wellbeing for all. Sincerely,
Academy of Nutrition and Dietetics, Alliance for Aging Research, American Academy of Family Physicians, American Association of Clinical Endocrinology, American Association of Nurse Practitioners, American College of Gastroenterology, American College of Lifestyle Medicine, American College of Occupational and Environmental Medicine, American College of Preventive Medicine, American Society for Nutrition, Ascension, Association of Diabetes Care & Education Specialists, Avery's Hope.
Biocom California, Blooming Health, Inc., California Chronic Care Coalition, Caregiver Action Network, Chronic Care Policy Alliance, Connected Health Initiative, COPD Foundation, Council For Affordable Health Coverage, Determined Health, Fight Colorectal Cancer, FundPlay Foundation, Geneoscopy, Gerontological Society of America, Global Liver Institute.
Healthcare Leadership Council, HealthyWomen, HIV + Hepatitis Policy Institute, Johnson & Johnson, Marshfield Clinic Health System, MemorialCare Health System, Merck, National Minority Quality Forum, Nevada Chronic Care Collaborative, NourishedRx, NTM Info & Research, Obesity Action Coalition, Obesity Medicine Association.
Partnership to Fight Chronic Disease, Partnership to Fight Infectious Disease, PLAY Sports Coalition, Premier Inc., Sports & Fitness Industry Association, Team Titin, Texas Health Resources, The Obesity Society, Tivity Health, UsAgainstAlzheimer's, Vizient, Wellvana, YMCA of the USA.
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Mr. BURGESS. Mr. Speaker, I urge all my fellow colleagues to join me in supporting H.R.
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Mr. BURGESS. Mr. Speaker, it is now my great privilege and high honor to yield 3 minutes to the gentleman from Texas (Mr. Arrington), the chairman of the Budget Committee, as we debate the first bipartisan budget bill to pass the floor of the House I think in the history of Congress.
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Mr. BURGESS. Mr. Speaker, may I inquire as to how much time is remaining.
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Mr. BURGESS. Mr. Speaker, I have no further speakers, and I reserve the balance of my time to close.
Mr. Speaker, I express my sincere gratitude to the gentleman from Texas (Mr. Arrington), my friend and the chairman of the Budget Committee, for his leadership. Also, I extend my appreciation to my fellow members of the Budget Committee for their unwavering support of this critical legislation.
I thank my former and current staff: James Paluskiewicz, Alexa Roberts, and Jacquelyn Incerto. Additionally, I express my appreciation for the Budget Committee staff--namely, Gary Andres, Paige Decker, Braden Murphy, and Charles Chapman--for their work in advancing this incredibly important bill.
I introduced the Preventive Health Savings Act back in 2012, driven by the belief that, too often, potentially transformative legislation is sidelined due to short-sighted budget constraints. We cannot afford to overlook the long-term benefits of preventive health measures for the well-being of our patients and the well-being of our Nation.
Preventive healthcare is not just about addressing immediate health concerns. It is about laying a foundation for a healthier future by proactively managing risks, reducing the incidence of chronic illnesses, and, ultimately, cutting down on healthcare costs.
With over 70 percent of healthcare spending attributed to chronic diseases, it is clear that investing in prevention is not just prudent but essential.
H.R. 766 is a crucial step forward. By establishing a mechanism for the Congressional Budget Office to accurately assess the long-term cost-savings potential of preventive health initiatives, this legislation enables us to make a more informed and forward-thinking policy decision.
Once again, I am grateful to everyone who played a part in moving this bill. I express my gratitude to Congresswoman DeGette for her invaluable partnership. I thank the gentlewoman from Minnesota (Ms. Omar), for her kind words today. Donna Christian-Christensen, our former colleague from the Virgin Islands, also assisted in this effort.
Words cannot express how grateful and honored I am. Let me just say, as a general rule, Mr. Speaker, I don't think it is a good idea that things be named after people while they are still alive. However, in this case, I actually made an exception. I am happy that my name is attached to this critical piece of legislation.
Let's continue to work together toward a future where preventive health is not just an afterthought but a cornerstone of our national healthcare policy and our public strategy.
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