[Congressional Record Volume 169, Number 17 (Thursday, January 26, 2023)]
[Senate]
[Page S122]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. CARDIN (for himself, Mr. Crapo, Mr. King, and Mr. Cramer):
  S. 114. A bill to amend the Congressional Budget Act of 1974 
respecting the scoring of preventive health savings; to the Committee 
on the Budget.
  Mr. CARDIN. Madam President, today I am proud to reintroduce the 
Preventive Health Savings Act. This bipartisan legislation would reform 
the Congressional Budget Office's CBO, scoring to better reflect the 
savings from preventive health initiatives by expanding the budgetary 
window the CBO evaluates.
  Currently, the CBO scores the budgetary implications of legislation 
over a 10-year period. Oftentimes, however, the cost-savings of 
preventive care are not clear within the current 10-year ``scoring'' 
window. This legislation would direct the CBO to extend its analysis 
beyond the existing 10-year budget window to two additional 10-year 
periods, which will give a truer picture of the benefits of health 
initiatives and better enable Congress to pass effective policies.
  Chronic and mental health conditions account for 90 percent of our 
Nation's $4.1 trillion in annual medical expenditures. In 2018, more 
than half of U.S. adults had 1 of 10 chronic conditions, and 27.2 
percent had multiple chronic conditions, and this number is only 
expected to grow. Chronic diseases disproportionally affect racial and 
ethnic minorities. For example, when compared to non-Hispanic White 
adults, Black adults are 1.6 times, Asian American adults are 1.4 
times, Hispanic adults are 1.7 times, American Indian and Alaska Native 
adults are 2.9 times, and Native Hawaiian and Pacific Islander adults 
are 2.5 times more likely to be diagnosed with diabetes. Additionally, 
Black adults are 1.4 times, American Indian and Alaska Native adults 
are 1.2 times, and Native Hawaiian and Pacific Islander adults are 1.3 
times more likely to have asthma than non-Hispanic Whites.
  As more Americans experience chronic conditions, the healthcare costs 
in the United States will continue to rise. Not only are these costs a 
heavy burden on millions of Americans and their families, but they are 
also primary drivers of our annual Federal budget deficits and 
accumulated debt. As medical expenditures continue to rise, it is 
crucial that we capture the long-term savings that can be achieved by 
focusing our efforts on averting, halting, or slowing preventable 
diseases. This is why I have long been a champion for expanded access 
to affordable, high-quality preventive health care and am proud to have 
championed initiatives from coverage for colon screenings to increased 
access to oral health care. But we still have progress to make.
  I am encouraged by the cutting-edge research that world-class 
institutions in my home State of Maryland, such as the National 
Institutes of Health, NIH, are doing to address chronic diseases. 
Interventions, including screenings, vaccinations, and behavioral 
changes, can prevent or delay the onset of new cases and mitigate the 
progression of a preventable illness, which can result in large 
reductions in the financial, physical, and emotional toll of developing 
one or more chronic diseases. By having the data to enable us as 
lawmakers to look at cost-benefit analyses, we can most effectively use 
our Nation's resources to improve the health of Americans while 
reducing medical costs. The first step to altering the trajectory of 
chronic diseases and curbing healthcare costs is to have more accurate 
information on the cost savings of preventive care.
  I thank Senators Crapo, King, and Cramer for joining me in 
introducing this legislation and urge my other Senate colleagues to 
consider cosponsoring the measure.
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