Lawmakers push changes to CBO scoring for preventive health

Jessie Hellmann, CQ-Roll Call on

Published in Political News

WASHINGTON — Almost every lawmaker remembers their first “bad” score from the Congressional Budget Office, the nonpartisan entity that estimates the budgetary and economic impacts of legislation.

For Rep. Diana DeGette, D-Colo., it was when she tried to get a bill passed that would mandate Medicare and Medicaid coverage of tobacco cessation services, including counseling and drugs.

At the time, the CBO told her that such a provision would raise the bill’s costs, despite her view that, as a preventive health measure, it would cost money upfront but save money in later years by reducing cancer and disease.

That frustration is part of what spurred her to join Rep. Michael C. Burgess, R-Texas, to regularly sponsor legislation that would allow chairs and ranking members of health and budget committees to request that CBO score preventive health measures over a longer period of time — up to 30 years.

Burgess and DeGette are now working to get their bill on the House suspension calendar after the House Budget Committee approved it 30-0 earlier this month. The bill has been named after Burgess, who is retiring at the end of this term.

“I think it will be a very potent shift in the way we look at health care policy,” DeGette said.


DeGette’s experience reflects the importance of receiving a ‘good’ CBO score — seen as no or minimal increases in spending — in order to get legislation through Congress.

A CBO estimate that a bill would raise spending can be a legislative death knell, forcing lawmakers to find a way to pay for it, reduce costs or change the legislation’s scope.

It’s also spurred some lawmakers and health care organizations to complain that the importance of CBO scores makes it difficult to pass health care legislation.

Health care groups like the American Medical Association and the American Academy of Family Physicians have lobbied in support of the bill, seeing it as a gateway to getting Congress to pass more health interventions that prevent chronic disease.


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