The Congressional Budget Office (CBO) director would gain stronger authority to access sensitive health care data from federal agencies with fewer delays under bipartisan legislation the Senate passed by unanimous consent on Tuesday (Sept. 10).
Although the bill doesn’t directly address the CBO’s interactions with federal health agencies, it is expected to have health care policy implications by helping the CBO overcome bureaucratic hurdles to secure essential health data and deliver faster, more accurate analyses of health care proposals.
The CBO Data Sharing Act [H.R.7032], introduced by House Budget Committee Chairman Jodey Arrington (R-TX) and ranking Democrat Brendan Boyle (PA) in January, would give the CBO director the authority to request and receive information, including sensitive data, from federal agencies without lengthy negotiations or formal agreements, provided confidentiality is upheld. The bill also ensures that future laws cannot unintentionally restrict the CBO’s access to such data unless explicitly stated.
“In order for the Congressional Budget Office (CBO) to provide lawmakers accurate and timely information about the cost of legislation, they need access to all relevant government data,” House Budget Committee Chairman Jodey Arrington (R-TX) said in a statement on Tuesday after the bill’s Senate passage. “Our budget reform bill will empower CBO to provide information critical to good public policy and stewardship of tax dollars.”
The House Budget Committee initially advanced the bill with a unanimous vote of 30-0 during a full committee markup on Feb. 6. It later passed the House on April 29 under suspension of the rules.
On the health policy front, the bill aims to prevent data-sharing roadblocks and ensure that Congress has more reliable information when considering changes to Medicare, Medicaid, and other public health policies.
For instance, in 2023, the CBO released a report on proposals to modify or eliminate the Institutions for Mental Diseases (IMD) exclusion that limits Medicaid funding for inpatient care in psychiatric hospitals or other mental health facilities. To fully assess the potential impact of these proposals, the CBO requested detailed data from CMS on facilities meeting the IMD criteria. However, CMS denied the request, citing legal restrictions under the Public Health Service Act of 2000.
As a result, the CBO had to rely on less detailed public information, which limited the accuracy of its analysis. Had this bill been in place, the CBO could have bypassed that bureaucratic hurdle and provided Congress with more reliable data, according to the House Budget Committee’s bipartisan fact sheet of the legislation.
The CBO Data Sharing Act is the second House-passed bill from the House Budget Committee that seeks to reform the government office that scores legislation, following the March 19 passage of the Dr. Michael C. Burgess Preventive Health Savings Act (H.R. 766). That bill requires CBO, upon request, to extend its analysis window from 10 to 30 years, to better capture long-term impacts and to enable policymakers to make more informed decisions about preventive health care and the nation’s fiscal health. The bill was amended during mark-up to clarify that the 30-year score cannot be used for pay-go
With Burgess set to retire in November at the end of his 11th term in Congress, and with the American Medical Association (AMA) advocating for the bill’s passage in its comments to the Senate Finance Committee’s physician payment reform efforts, there’s a strong chance the Senate will act on it soon–either before the November elections or during the lame-duck session.
But this might not be the only CBO reform proposal seen from Burgess before his retirement. During a House Budget Committee hearing on Wednesday (Sept. 11) focused on improving the CBO, he suggested codifying the role of the CBO’s health advisory panel in providing technical recommendations for the agency’s health care models and estimates.
The CBO’s panel of health advisors provides guidance on health policy issues to improve the accuracy and relevance of its analyses and cost estimates. Burgess says formalizing the panel’s role would strengthen congressional oversight of the agency, particularly after it projected a lower number of new drugs that could be negatively impacted by the Inflation Reduction Act’s prescription drug price negotiations compared to other economists.
CBO Director Phillip Swagel pushed back on Burgess’ suggestion, warning that codifying the panel’s role could introduce political dynamics and compromise its non-partisan, expert-driven mission.
“[The panel] is non-political, and I would worry about moving it, even inadvertently, toward the political side,” Swagel, serving as a witness, said during Wednesday’s oversight hearing.
Senate Unanimously Passes CBO Data Sharing Act, Expected To Streamline Health Policy Analysis
Inside Heath Policy
September 12, 2024 3:10 am
The Congressional Budget Office (CBO) director would gain stronger authority to access sensitive health care data from federal agencies with fewer delays under bipartisan legislation the Senate passed by unanimous consent on Tuesday (Sept. 10).
Although the bill doesn’t directly address the CBO’s interactions with federal health agencies, it is expected to have health care policy implications by helping the CBO overcome bureaucratic hurdles to secure essential health data and deliver faster, more accurate analyses of health care proposals.
The CBO Data Sharing Act [H.R.7032], introduced by House Budget Committee Chairman Jodey Arrington (R-TX) and ranking Democrat Brendan Boyle (PA) in January, would give the CBO director the authority to request and receive information, including sensitive data, from federal agencies without lengthy negotiations or formal agreements, provided confidentiality is upheld. The bill also ensures that future laws cannot unintentionally restrict the CBO’s access to such data unless explicitly stated.
“In order for the Congressional Budget Office (CBO) to provide lawmakers accurate and timely information about the cost of legislation, they need access to all relevant government data,” House Budget Committee Chairman Jodey Arrington (R-TX) said in a statement on Tuesday after the bill’s Senate passage. “Our budget reform bill will empower CBO to provide information critical to good public policy and stewardship of tax dollars.”
The House Budget Committee initially advanced the bill with a unanimous vote of 30-0 during a full committee markup on Feb. 6. It later passed the House on April 29 under suspension of the rules.
On the health policy front, the bill aims to prevent data-sharing roadblocks and ensure that Congress has more reliable information when considering changes to Medicare, Medicaid, and other public health policies.
For instance, in 2023, the CBO released a report on proposals to modify or eliminate the Institutions for Mental Diseases (IMD) exclusion that limits Medicaid funding for inpatient care in psychiatric hospitals or other mental health facilities. To fully assess the potential impact of these proposals, the CBO requested detailed data from CMS on facilities meeting the IMD criteria. However, CMS denied the request, citing legal restrictions under the Public Health Service Act of 2000.
As a result, the CBO had to rely on less detailed public information, which limited the accuracy of its analysis. Had this bill been in place, the CBO could have bypassed that bureaucratic hurdle and provided Congress with more reliable data, according to the House Budget Committee’s bipartisan fact sheet of the legislation.
The CBO Data Sharing Act is the second House-passed bill from the House Budget Committee that seeks to reform the government office that scores legislation, following the March 19 passage of the Dr. Michael C. Burgess Preventive Health Savings Act (H.R. 766). That bill requires CBO, upon request, to extend its analysis window from 10 to 30 years, to better capture long-term impacts and to enable policymakers to make more informed decisions about preventive health care and the nation’s fiscal health. The bill was amended during mark-up to clarify that the 30-year score cannot be used for pay-go
With Burgess set to retire in November at the end of his 11th term in Congress, and with the American Medical Association (AMA) advocating for the bill’s passage in its comments to the Senate Finance Committee’s physician payment reform efforts, there’s a strong chance the Senate will act on it soon–either before the November elections or during the lame-duck session.
But this might not be the only CBO reform proposal seen from Burgess before his retirement. During a House Budget Committee hearing on Wednesday (Sept. 11) focused on improving the CBO, he suggested codifying the role of the CBO’s health advisory panel in providing technical recommendations for the agency’s health care models and estimates.
The CBO’s panel of health advisors provides guidance on health policy issues to improve the accuracy and relevance of its analyses and cost estimates. Burgess says formalizing the panel’s role would strengthen congressional oversight of the agency, particularly after it projected a lower number of new drugs that could be negatively impacted by the Inflation Reduction Act’s prescription drug price negotiations compared to other economists.
CBO Director Phillip Swagel pushed back on Burgess’ suggestion, warning that codifying the panel’s role could introduce political dynamics and compromise its non-partisan, expert-driven mission.
“[The panel] is non-political, and I would worry about moving it, even inadvertently, toward the political side,” Swagel, serving as a witness, said during Wednesday’s oversight hearing.