Recently, Senators Mark Warner (D-VA) and Michael Crapo (R-ID) introduced the Long-Term SCORE Act (S. 2260) which would allow the Congressional Budget Office (CBO) to estimate the budget impact of certain bills outside the normal 10-year scoring window. A companion bill (H.R. 282) was introduced in the House by Representative Reid Ribble (R-WI) in January 2015 and currently has 19 Democratic and 14 Republican co-sponsors.
CBO’s role is to analyze proposed legislation to assess its impact on both federal expenditures and revenues, providing lawmakers with projections of the net cost or net savings to the federal budget should a bill under consideration be enacted. Typically, the results are reported on a yearly, cash-flow basis for 10 years. While adequate for many bills, the 10-year window can fail to capture the full picture for prevention policies because these types of policies tend to require an investment up front and may not fully realize savings from improved health for decades. Under the traditional scoring model, savings beyond year 10 are unaccounted for, which can cause a bill to look expensive in the short term even if it is low-cost or even cost-saving in the long term.
The Long-Term SCORE Act would allow for a more complete accounting of the potential costs and benefits of prevention policies. BPC’s Prevention Task Force, which released its report, A Prevention Prescription for Improving Health and Health Care in America, also grappled with this issue, recommending that CBO use “present discount accounting” (also known as “net present value”) to assess the longer-term returns on investments in prevention. While a different approach than the Long-Term SCORE Act, both seek to provide Congress with a useful tool for evaluating the budget impacts of prevention policies.
BPC applauds the continued bipartisan work in both the Senate and the House to address this problem.