House Takes Steps to Get Truer Accuracy in Healthcare Estimates

Legislation is aimed at nonpartisan agency to account for multi-year, downstream effects.

On March 19, the U.S. House of Representatives passed H.R. 766, a bipartisan bill that will allow the Congressional Budget Office (CBO) to analyze and create budgetary savings estimates of preventive healthcare legislation over a 30-year budget window. The current scoring window for CBO is 10 years, but the full cost-saving potential of preventive healthcare legislation often occurs over a longer period, resulting in budgetary costs. This bill will encourage policies focused on medical innovation to result in savings over longer periods.

In remarks delivered on the House floor, the chief sponsor of the legislation, Rep. Michael Burgess (R-Texas) claimed that “chronic diseases account for over 70 percent of healthcare 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 healthcare initiatives. 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 healthcare costs for Americans.”

Burgess also claimed that “…healthcare costs are the chief debt driver of the federal budget, accounting for more than 1/3 of overall spending, a total that tops nearly $2 trillion dollars of taxpayer funds annually,” and that “investment in our nation’s healthcare innovation has the benefit of being a triple threat for patients everywhere: modernized technologies improve the likelihood of quality outcomes, and increase patient access, while also reducing the fiscal burden for taxpayers.”1

Joining Burgess in support of the bill was House Ways and Means committee chair Rep. Jason Smith (R-Mo.), who stated, “This bill ensures that the Congressional Budget Office, the official scorekeeper of Congress, is more accurately reflecting the long-term fiscal impact of policies. In this case, policies that have the potential to lower the cost of the ever-growing federal spending on health care – a major part of our nation’s annual budget.” Smith added, “As chairman of the House Ways and Means Committee, these are exactly the type of policies I want our Committee to consider, which can truly upend the healthcare system as we know it.”2

Why this matters to chiropractic is simple: Since its inception, CBO has focused specifically on the short-term valuation of policy, at the maximum 10 years, rather than trying to capture the longer-term economic impact. This new policy will certainly be of value when scoring the Chiropractic Medicare Coverage Modernization Act, especially in light of the recent systematic review that revealed that patients with spine-related musculoskeletal pain who consulted a chiropractor as their initial provider incurred substantially decreased downstream healthcare services and associated costs, resulting in lower overall healthcare costs compared with medical management.3

The legislation now goes to the Senate where the outlook for passage is positive.

John Falardeau is ACA’s senior vice president of public policy and advocacy.

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