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IHPC Assembly: House Budget Committee staffer calls this an exciting time for integrative health care policy
An exciting time is what Charlie Chapman, guest speaker at the recent October IHPC Assembly meeting predicted for integrative health policy. Chapman is a professional staff member for the U.S. House of Representatives Budget Committee, serving under Jodey C. Arrington (R-Tex). Chapman joined the assembly meeting to provide some background on the committee’s legislative process as it pertains to healthcare policy. The committee has responsibility for the federal budget, a big part of which is used for health care, and it works with House leadership to monitor how policy would impact budgetary spending. It also has direct responsibility and oversight over the Congressional Budget Office.
“The way the Congressional Budget Office (CBO) reports on legislation is often determinative in the success of the legislation,” Chapman told the group. The reason for this, he explained, is that almost all new policies need to be offset by decreases in spending. So, if there is a $5 million increase, we need to find that somewhere else and typically, he said, some other policy is on the losing end of that stick. “That is how we end up with the political gridlock we often deal with.”
Chapman discussed the process in relation to the recent passage in the House of Representatives of the Preventive Health Savings Act (HR 766), noting it as an example of how the committee works with health care stakeholders. The bill would provide a framework for the Congressional Budget Office (CBO) to evaluate the long-term budget impacts of preventive health care legislation. The committee put out an RFI earlier this year to which IHPC and other Partners for Health responded. “The reach was really good,” Chapman said, noting they got input across the spectrum from small rural practitioners to major trade groups.
A recurring theme that came up in the RFI submissions, Chapman added, was that the way the CBO was scoring certain policies didn’t consider their long-term impact. The comments prompted a discussion about the fact that 10 years is too short to evaluate the impact, Chapman said.
HR 766 requires the Congressional Budget Office (CBO), upon receiving a request from Congress, to determine if proposed legislation would reduce spending outside of the 10-year budget window through the use of preventive health and preventive health services. “Providing access to healthcare for two or three years can improve health for decades,” he added.
The committee worked to create a policy that was implementable and politically feasible. “We were able to pass the bill unanimously on the House floor, which is very rare,” he said. “We are hoping to get it done this year in the Senate.”
Chapman called the current era an exciting time for integrative health policy as many Congress members are starting to understand that health care is not a one-size-fits-all proposition. They now understand, he said, that they need to look past the current models and look more closely at ways to support personalized medicine, strengthen the practitioner/patient relationship, and develop models that are lower cost and more transparent.
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