[Congressional Record Volume 170, Number 48 (Tuesday, March 19, 2024)]
[House]
[Pages H1204-H1209]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          DR. MICHAEL C. BURGESS PREVENTIVE HEALTH SAVINGS ACT

  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.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Texas (Mr. Burgess) and the gentlewoman from Minnesota (Ms. Omar) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Texas.


                             General Leave

  Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material into the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume.
  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

[[Page H1205]]

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.

  Mr. BURGESS. Mr. Speaker, I urge all my fellow colleagues to join me 
in supporting H.R. 766 and ensuring that we continue to prioritize 
preventive healthcare initiatives for the betterment of all Americans, 
and I reserve the balance of my time.
  Ms. OMAR. Mr. Speaker, I yield myself such time as I may consume.

[[Page H1206]]

  Mr. Speaker, I rise in support of H.R. 766. The Dr. Michael C. 
Burgess Preventive Health Savings Act provides Congress with more 
information on the budgetary impact of preventive healthcare services.
  Investing in prevention, such as early detection screenings, could 
improve healthcare outcomes while lowering healthcare costs in the long 
run.
  Such lifesaving, evidence-based policies often have significant 
fiscal benefits for the government. The bill also ensures that the 
requests for this outyear estimate are bipartisan.
  Both the chair and the ranking member of the Budget Committee and the 
primary committees of jurisdiction must all together request this 
information.
  This request should be about our continued focus on wellness and 
disease prevention for the American people and not be used to justify 
any partisan policies.

                              {time}  1630

  Finally, the bill ensures that the out-year impact of prevention 
healthcare policies are only used as a supplemental estimate. It cannot 
be used for any budgetary enforcement controls. This would simply help 
Congress make more informed policy decisions and prevent out-year 
estimates to be used for any budget gimmicks.
  I fully support this sensible piece of legislation, bringing us 
closer to more transparent and holistic budget reporting.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield 1 minute to the gentlewoman from 
Minnesota (Mrs. Fischbach).
  Mrs. FISCHBACH. Mr. Speaker, I thank my colleague from Texas for 
yielding me the time and for bringing this piece of legislation 
forward.
  Mr. Speaker, we know that investing in preventive care benefits an 
individual's health and pocketbook in the long run. Unfortunately, 
current statute only allows the Congressional Budget Office to assess a 
10-year cost estimate window, despite the fact that assessing the 
impact of preventive care usually takes much longer than that.
  I proudly support the Dr. Michael C. Burgess Preventive Health 
Savings Act, which allows the CBO to score the long-term cost benefit 
of preventive care. This is a simple bill, and it will not only benefit 
the health of Americans, but it will also save taxpayer dollars.
  Ms. OMAR. Mr. Speaker, I yield 5 minutes to the gentlewoman from 
Colorado (Ms. DeGette), the coauthor of the legislation.
  Ms. DeGETTE. Mr. Speaker, I rise in strong support of the Dr. Michael 
C. Burgess Preventive Health Savings Act.
  A great frustration for those of us who work a lot on healthcare 
policy is the difficulty in accurately predicting the cost of 
preventive care. Right now, as you heard from my coauthor of the bill, 
Dr. Burgess, when Congress looks at the cost and benefits of preventive 
healthcare, we only look at a 10-year window. That is true even when 
the savings associated with preventive care would accrue 15, 20, 30 
years in the future.
  That is why Dr. Burgess and I wrote this bill, so that we could look 
at preventive care over a longer time frame and actually see the cost 
savings that it will give us. That will help us refocus our healthcare 
legislation on prevention rather than waiting until serious diseases 
occur.
  Preventive care averts illnesses, helps catch problems before they 
get too bad, and also saves lives. It has another benefit. It saves 
money. Therefore, Congress should be able to consider how preventive 
healthcare saves taxpayers' dollars when we prepare to vote on 
legislation.
  This bill provides a framework for committees to request an extended 
estimate for legislation related to preventive healthcare from the 
Congressional Budget Office. With the framework laid out in this bill, 
committees can, on a bipartisan basis, request an estimate of the 
effects of a preventive healthcare bill up to a 30-year window.
  This sounds a little technical but, frankly, I believe it will 
revolutionize how Congress considers preventive healthcare legislation. 
It is going to make it so Congress will have long-term cost estimates 
on preventive care legislation from a nonpartisan, trusted source.
  As new innovations to keep Americans healthy are developed, we can 
better consider their long-term effects as we try to make them more 
available to the American people.
  At the same time, as you heard, this bill does not allow any new 
budgetary gimmicks. Instead, it just gives us the framework to get the 
information we need.
  Part of the genesis of this bill was when Dr. Burgess and I and 
others were working on the Affordable Care Act. I really wanted to put 
in the mandated benefits the inclusion of smoking cessation.
  Now, everybody in this room and in the gallery knows, helping 
Americans stop smoking cigarettes is one of the most obvious areas 
where preventive care can just save lives but also save money. We all 
know the terrible results of smoking: higher risks of lung cancer, 
diabetes, stroke, heart disease, COPD, and more. Treating these 
conditions is expensive, but it is also deadly for people.
  CBO was working on this 10-year window when it made an estimate on my 
ideas, and they said: Congresswoman, we think the idea of smoking 
cessation is a great idea, but, unfortunately, the smoking cessation 
programs like the patch and Nicorette and things like that are just too 
expensive, and so we can't afford to pay for them as part of the 
mandated benefits of the ACA. To me, that is crazy, and that is why we 
need this bill.
  Dr. Burgess and I have been working on this bill ever since, over 10 
years now, and I am proud to see it come to the floor. Here it is now. 
It is among the first bipartisan bills from the Budget Committee to be 
reported to the full House in years.
  We talk a lot about needing a long-term view. I can't think of a 
better example of a long-term view than a bill that takes more than 10 
years, but yet we persevere.
  Finally, I thank  Mike Burgess for his partnership on this bill and 
his partnership on the Energy and Commerce Committee for many other 
bills. We disagree a lot, but we have found a lot of common ground, and 
we always work in good faith to deliver for our constituents and the 
American people.
  This bill is a perfect example of how we work together to write 
commonsense legislation that centers on what Americans need to lead 
healthy lives. It is truly a bipartisan victory. It is good 
legislation. I am going to miss Dr. Burgess and his vision on the 
committee. I hope that we can work together to get this bill through 
the other body just as quickly as we can. I urge a ``yes'' vote on this 
bill.
  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.

  Mr. ARRINGTON. Mr. Speaker, I thank the gentleman from Texas. What a 
great career he has had in public service. He has truly been an 
inspiration and a leader among his equals here in the people's House on 
healthcare issues. He was the founder of the Doctors Caucus. He was the 
Health Subcommittee chair at the Energy and Commerce Committee and the 
chair of the Health Care Task Force on the Budget Committee. There is 
nobody in this Chamber, and I would submit in the United States 
Congress, who knows more about healthcare and who has endeavored more 
over the years to make healthcare work.
  Mr. Speaker, I thank my Democratic colleagues, Ms. Omar and Ms. 
DeGette. This is proof that we can work together in good faith, find 
common ground and consensus solutions to make this country and its 
government work for the people.
  I thank Ms. DeGette for her kind words. We have young people in the 
gallery who got to hear something they don't often hear on cable news, 
which is a colleague from one side of the aisle complimenting another. 
What great decorum. What a great example of civil discourse in their 
Nation's Capitol. They need to see more of it.
  I am grateful that we have an opportunity to address the triple aim 
in healthcare that often is underutilized because of simply the way we 
score it.

[[Page H1207]]

Healthcare innovation and technology can improve access and quality 
outcomes while bending the curve on costs, not just to our patients and 
to our fellow Americans, but also to the taxpayers. Healthcare is a 
third of the budget. It is a big driver of our debt, and we have got to 
look for commonsense solutions to improve across the board these 
important outcomes. Again, I thank Ms. Omar and Ms. DeGette for their 
leadership.
  To my friend from the great State of Texas, what a legacy. We named 
this bill after Dr. Burgess. He was loath to allow that, but it is 
appropriate because of all that he has done to leave this country 
better than he found it. This no doubt will have a tremendous impact 
for the future. May God bless my friend, and Godspeed.
  Ms. OMAR. Mr. Speaker, I have no further speakers, and I am prepared 
to close. I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield 1 minute to the gentleman from Ohio 
(Mr. Wenstrup), the co-chair of the Doctors Caucus.
  Mr. WENSTRUP. Mr. Speaker, I am here today in support of the Dr. 
Michael C. Burgess Preventive Health Saving Act, a bill aptly named 
after my colleague and friend, my co-chair on the Doctors Caucus, Dr.   
Michael Burgess.
  This important legislation is going to allow the Congressional Budget 
Office to measure the long-term impact of health policies, breaking 
free from the arbitrary 10-year budget window that currently constrains 
our ability to help our fellow Americans to live a healthier and longer 
life.
  This is something that we as the Doctors Caucus have met with CBO on. 
They were not sure how to do it. Dr. Burgess put forward a way that we 
can get this done. We worked in a bipartisan manner to enact policies 
that can bring patients more access to drugs, treatments, cures.
  Yet, when looking at the initial cost of bringing new treatments and 
drugs to patients, the long-term savings that are associated with 
keeping Americans healthier for longer are not considered. They need to 
be. The Congressional Budget Office should have the ability to fully 
score the impact that reductions in obesity, access to early and 
preventive treatments, and keeping patients healthier will have on 
Medicare, for example.
  It has been my great honor to serve with Dr. Burgess on the Doctors 
Caucus and here in Congress. I am glad to support this bill led by Dr. 
Burgess, whose expertise and desire for quality care for all Americans 
has inspired many to practice medicine and encourage them to get 
involved with government. I encourage support of this bill.
  Mr. Speaker, I include in the Record a letter from the American 
Medical Association supporting H.R. 766.

                                 American Medical Association,

                                      Chicago, IL, March 18, 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: On 
     behalf of the physician and medical student members of the 
     American Medical Association (AMA), I am writing in support 
     of H.R. 766, the ``Dr. Michael C. Burgess Preventive Health 
     Savings Act.'' This bipartisan bill would provide leaders in 
     Congress with the ability to request that the Congressional 
     Budget Office (CBO) provide an estimate of the long-term 
     health savings that are possible from preventive health 
     initiatives.
       Chronic disease is a leading cause of death and disability 
     in the United States. According to the Centers for Disease 
     Control and Prevention, each year more than 877,500 Americans 
     died of heart disease or stroke, more than 1.7 million people 
     were diagnosed with cancer, and more than 37.3 million 
     Americans have diabetes, with an additional 96 million adults 
     diagnosed with prediabetes, which puts them at risk for type 
     2 diabetes. These diseases, along with other conditions such 
     as obesity, Alzheimer's, and mental health issues, place a 
     significant burden on the economy, accounting for 90 percent 
     of our nation's $4.1 trillion in annual health care spending. 
     These figures will undoubtedly worsen as the population ages.
       Congress should be able to consider the long-term economic 
     benefits of legislation that would promote wellness and 
     disease prevention initiatives that reduce chronic 
     conditions. However, the way in which the CBO currently 
     ``scores'' legislation severely constrains the ability of 
     policymakers to accurately assess legislation that would 
     prevent chronic disease. For example, while research has 
     demonstrated that certain expenditures for preventive 
     medicine generate savings when considered in the long term, 
     those cost savings may not be evident when evaluating only 
     the first 10-year ``scoring'' window.
       We believe this legislation represents a significant step 
     towards providing Congress with the means to obtain a more 
     relevant long-term economic picture of the benefits of 
     legislation to prevent chronic diseases. The legislation 
     would allow, among other things, the Chair and Ranking member 
     of the budget and health-related committees in the House or 
     Senate to jointly request an analysis of the two 10-year 
     periods beyond the existing initial 10-year window. The 
     provisions requiring these requests to come jointly from the 
     Chair and Ranking Member of the budget and health-related 
     committees in the House or the Senate will ensure the CBO is 
     not diverted to frivolous or overly partisan analyses. 
     Furthermore, the legislation's definition of ``preventive 
     health'' appropriately captures the unique nature of this 
     concept by including actions that focus on the health of the 
     public, individuals, and defined populations to protect, 
     promote, and maintain health and wellness, as well as prevent 
     disease, disability, and premature death as demonstrated in 
     credible, publicly available studies and data.
       The AMA applauds your leadership in bringing this important 
     legislation to the House floor for consideration and looks 
     forward to working with you on this and other efforts to 
     promote wellness and increase chronic disease prevention.
           Sincerely,
                                              James L. Madara, MD.
  Ms. OMAR. Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield 1 minute to the gentleman from 
Indiana (Mr. Bucshon), a member of the Energy and Commerce Committee 
and a member of the Doctors Caucus.
  Mr. BUCSHON. Mr. Speaker, I recognize the legacy of Dr. Michael 
Burgess and support this bill, H.R. 766.
  If Members of Congress can agree on one thing, it is that we seek to 
improve the lives of our constituents. Unfortunately, CBO's current 
approach to how it develops cost estimates for healthcare legislation 
interferes with that goal by failing to take into account all the 
future benefits of the legislation.
  CBO's current approach keeps Federal healthcare programs stuck in the 
status quo of simply providing care when you get sick, including 
expensive care, instead of focusing on providing care that keeps you 
healthy and hopefully from needing more expensive forms of care down 
the road.
  CBO's current approach defies common sense, and it is imperative that 
Congress directs CBO to more accurately reflect the long-term cost 
saving potential of preventive healthcare initiatives. That is why I am 
proud to support H.R. 766.
  To ensure Congress can better evaluate meaningful and impactful 
healthcare policies that bolster access and quality of care, Congress 
must pass this bill.
  Mr. Speaker, I include in the Record a letter from the Community 
Oncology Alliance supporting H.R. 766.


                                  Community Oncology Alliance,

                                   Washington, DC, March 18, 2024.
     Re Community Oncology Alliance Support of The Dr. Michael C. 
         Burgess Preventative Health Savings Act (H.R. 766).

     Hon. Jodey Arrington,
     Chairman, House Budget Committee,
     Washington, DC.
       Dear Chairman Arrington: On behalf of the Board of 
     Directors of the Community Oncology Alliance (``COA''), we 
     applaud the House Budget Committee for advancing The Dr. 
     Michael C. Burgess Preventative Health Savings Act (H.R. 766) 
     to a floor vote of this important bipartisan legislation 
     sponsored by Congressman Dr. Burgess with Congresswoman Diana 
     DeGette.
       As you know, COA is an organization dedicated to advocating 
     for the complex care and access needs of patients with cancer 
     and the community oncology practices that serve them. COA is 
     the only non-profit organization in the United States 
     dedicated solely to independent community oncology practices, 
     which serve the majority of Americans receiving treatment for 
     cancer. Since its grassroots founding over 20 years ago, 
     COA's mission has been to ensure that patients with cancer 
     receive quality, affordable, and accessible cancer care in 
     their own communities where they live and work, regardless of 
     their racial, ethnic, demographic, or socioeconomic status.
       The limitation of the 10-year scoring window is a severe 
     obstacle to realizing the savings from preventive health care 
     legislation. It is unrealistic to expect that many, if not 
     most, preventative health care initiatives can return 
     positive savings by 10 years. As a result of the current 
     scoring mandate on the Congressional Budget Office, many, if 
     not most, preventative health care initiatives

[[Page H1208]]

     are not implemented because of funding constraints.
       With cancer, we have more effective treatments, but it is 
     essential that we look for ways of preventing this disease 
     that impacts so many Americans. Unfortunately, artificial 
     scoring mandates undermine the adoption of preventive care 
     initiatives. As a result, COA supports the passage of H.R. 
     766, and we greatly appreciate your work and that of your 
     staff in the landmark advancement of this legislation out of 
     your committee.
           Sincerely,
                                                         Ted Okon,
                                               Executive Director.

  Ms. OMAR. Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield 2 minutes to the gentleman from 
Missouri (Mr. Smith), the chairman of the Ways and Means Committee.
  Mr. SMITH of Missouri. Mr. Speaker, I wish to commend Dr. Burgess for 
his steadfast leadership working in a bipartisan and bicameral manner 
to bring this important piece of legislation forward.
  This bill ensures that the Congressional Budget Office, the official 
scorekeepers 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 
healthcare, a major part of our Nation's annual budget.
  It also has the added benefit of encouraging preventive healthcare 
policies that can lower the risk of illness and chronic disease among 
our fellow citizens, leading to a healthier Nation.
  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.
  In short, this bill promotes both the fiscal health of the country 
and the physical health of its people.

                              {time}  1645

  As the former Republican leader of the House Budget Committee, I have 
had the honor of fighting alongside Dr. Burgess in the trenches of 
fiscal policy. Together, we have worked to ensure CBO is aiding, not 
preventing, investments in bold healthcare reform.
  This bill is a key victory in every effort.
  Ms. OMAR. Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield 1 minute to the gentleman from 
Georgia (Mr. Carter), a fellow member of the Energy and Commerce 
Committee.
  Mr. CARTER of Georgia. Mr. Speaker, I rise today in strong support of 
H.R. 766, the Dr. Michael C. Burgess Preventive Health Savings Act.
  This bipartisan legislation will reform the Congressional Budget 
Office's scoring to better reflect the savings from preventive health 
initiatives by expanding the budgetary window that CBO evaluates. 
Currently, CBO scores a bill's budget impacts over a 10-year window, 
often missing the long-term savings achieved through preventative care.
  As we all know, preventative healthcare lowers costs and ensures 
Americans can live healthier lives, while also saving money for 
patients and taxpayers. However, current restrictions prevent CBO from 
considering long-term savings generated by preventative healthcare when 
it evaluates legislation.
  The Dr. Michael C. Burgess Preventive Health Savings Act would allow 
CBO to expand its analysis beyond the existing 10-year budget window to 
two additional 10-year periods, which will enable Congress to better 
evaluate meaningful and impactful policies.
  As Dr. Burgess often says, an ounce of prevention is worth a pound of 
cure. This bipartisan bill is commonsense legislation that would help 
bend the cost curve and provide better patient care.
  I thank Dr. Burgess for working on this important issue, and I urge 
my colleagues to support this legislation.
  Mr. Speaker, I include in the Record a letter from the Council for 
Affordable Health Coverage supporting H.R. 766.

                                            Council for Affordable


                                              Health Coverage,

                                                   March 18, 2024.
     Hon. Jodey Arrington,
     Chairman, Committee on the Budget,
     Washington, DC.
     Hon. Brendan Boyle,
     Ranking Member, House Budget Committee,
     Washington, DC.
       Dear Chairman Arrington and Ranking Member Boyle: The 
     Council for Affordable Health Coverage (CAHC) writes to 
     express our support for H.R. 766, the Dr. Michael C. Burgess 
     Preventive Health Savings Act because it will begin to change 
     how Congress views preventing health illnesses before they 
     become expensive chronic conditions.
       In any given year, the healthiest half of the population 
     accounts for less than 3 percent of health care spending. 
     Most spending goes toward the treatment of chronic 
     conditions, such as heart failure or diabetes, which are long 
     in duration and have no definite cure. Patients with two or 
     more chronic diseases account for 84 percent of health 
     spending. Left untreated, chronic conditions multiply. For 
     example, diabetes carries high risks of heart disease and 
     hypertension, which in turn carry high risks of heart attacks 
     and strokes. For this reason, self-neglect is a major driver 
     of medical spending. Many patients under care for chronic 
     conditions fail to take their medicines--a problem that could 
     cost as much as $6 trillion over the next decade. Obesity, a 
     precursor to diabetes, is among the most expensive cost 
     drivers.
       When Congress first enacted the Medicare Modernization Act, 
     Medicare Part D, CBO gave Congress no savings that would 
     accrue to the benefits of taking medicines that prevent heart 
     attacks, stroke, cancers, diabetes, obesity, and other 
     chronic conditions. None. Faced with mountains of evidence, 
     CBO revised their methodology in 2012 to reflect the benefit 
     of adherence to medications as a way to lower spending on 
     medical services, giving partial savings to increased drug 
     utilization. That change reflects common sense--people take 
     medicines to stay healthy and treat disease.
       The way CBO scores legislation downplays the long term 
     benefit of preventing illness in the first place. This 
     constrains the ability of Congress to judge the merits of 
     health legislation by skewing costs in favor of benefits. A 
     balanced approach is required to allow sound decisions.
       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. 
     Without an independent and unbiased understanding of how 
     these benefit mandates impact premiums, we cannot understand 
     how policy changes may impact taxpayer and individual costs.
       We applaud your leadership on this critical issue and 
     encourage Congress to pass the legislation quickly to bring 
     more clarity to its deliberations.
           Sincerely,
                                                    Joel C. White,
                                                        President.

  Ms. OMAR. Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield 1 minute to the gentleman from 
Texas (Mr. Moran).
  Mr. MORAN. Mr. Speaker, I rise today in support of the reintroduction 
of H.R. 766, the Dr. Michael C. Burgess Preventive Health Savings Act, 
named in honor of my fellow Texan, friend, and champion for patients, 
Dr. Burgess.
  This bipartisan, bicameral, lifesaving legislation would direct the 
CBO to more accurately reflect the long-term cost-saving potential of 
preventive healthcare initiatives.
  Congress should recognize the impact that preventive healthcare can 
have on an individual's life, as well as the long-term cost-saving 
potential.
  Current restrictions prevent the CBO from fully examining the 
accurate economic impacts of preventive measures when they evaluate 
health legislation, but H.R. 766 goes beyond the normal 10-year window 
to allow Congress to better evaluate the potential for budgetary 
savings of preventive healthcare legislation and to ensure that it is 
done with the best interest of the American taxpayers in mind.
  If we are going to tackle the growing cost of medical care for 
individuals and find legislative solutions to mandatory healthcare 
parameters that account for at least one-third of the Federal budget, 
then we must seek transparency first.
  Mr. Speaker, I urge my colleagues to support H.R. 766.
  Ms. OMAR. Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield 1 minute to the gentleman from 
Indiana (Mr. Yakym).
  Mr. YAKYM. Mr. Speaker, I rise today to express my strong support for 
the Dr. Michael C. Burgess Preventive Health Savings Act.
  This bipartisan bill is essential to helping us, as lawmakers, make 
the most informed decisions possible when it comes to preventive 
healthcare legislation.
  So often, when the CBO scores preventive health measures, the 10-year 
scoring window greatly limits their ability to show the full impact of 
the legislation. This bill would allow such

[[Page H1209]]

measures to be scored over a 30-year timeframe, giving us a more 
accurate picture of the impact the policy would have.
  I am proud to be a cosponsor of this bill, which originated in the 
House Budget Committee. I look forward to voting in favor of this piece 
of legislation, and I urge my colleagues to do the same.
  Mr. Speaker, I include in the Record a letter from the Bipartisan 
Policy Center in support of H.R. 766.


                              Bipartisan Policy Center Action,

                                   Washington, DC, March 18, 2024.
     Hon. Michael C. Burgess, M.D.,
     Washington, DC.
     Hon. Diana DeGette,
     Washington, DC.
       Dear Congressman Burgess and Congresswoman DeGette, BPC 
     Action commends you for your leadership in introducing and 
     advancing H.R. 766, The Preventive Health Savings Act (PHSA). 
     BPC Action supports this bipartisan effort to better account 
     for the full impact of preventive health care in 
     Congressional Budget Office (CBO) estimates and encourages 
     all members to support the bill on the House floor this week.
       The Bipartisan Policy Center (BPC) has long focused on the 
     importance of prevention. In 2014, BPC's Prevention Task 
     Force--advised by former Senate Majority Leader Bill Frist, 
     Agriculture Secretary Dan Glickman, and former CBO director 
     Alice Rivlin--recommended that the CBO use ``present discount 
     accounting'' to bring long-term savings from prevention 
     ``up'' in time and to align better with CBO's current 10-year 
     scoring window. This could have helped ensure that CBO 
     accounts for benefits that might be seen 20-25 years out. 
     While slightly distinct in method but similar on principle, 
     the Preventive Health Savings Act would provide policymakers 
     with information related to the benefits of disease 
     prevention and health promotion beyond the 10-year scoring 
     window to 20- and 30-years out.
       Further, in 2019, BPC Chief Medical Advisor Dr. Anand 
     Parekh in his book Prevention First (advised by former Senate 
     Majority Leaders Bill Frist and Tom Daschle) recommended 
     greater funding for prevention research so that there are 
     more published studies and a better evidence-base for CBO to 
     determine the cost-effectiveness of prevention interventions 
     and more appropriately score future federal legislation 
     related to prevention.
       BPC Action applauds your commitment to this issue and urges 
     Congress to pass the Preventive Health Savings Act.
           Sincerely,
                                                Michele Stockwell,
                                                        President.
  Ms. OMAR. Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I reserve the balance of my time.
  Ms. OMAR. Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, may I inquire as to how much time is 
remaining.
  The SPEAKER pro tempore. The gentleman from Texas has 6\1/2\ minutes 
remaining.
  Mr. BURGESS. Mr. Speaker, I have no further speakers, and I reserve 
the balance of my time to close.
  Ms. OMAR. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, preventive healthcare services can save lives and lower 
costs for families. It is time for Congress to evaluate and prioritize 
such innovative policies that have the potential to improve our 
healthcare system.
  I appreciate the hard work of Representative Burgess and congratulate 
him on his retirement and Representative DeGette in championing this 
important effort 11 years in the making. I was proud to vote for this 
bill in committee, and I urge my colleagues to support it today.
  Mr. Speaker, I yield back the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield myself the balance of the time.
  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.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Texas (Mr. Burgess) that the House suspend the rules and 
pass the bill, H.R. 766, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________