Preventive Health Savings Act

Madam President, today I am proud to reintroduce the Preventive Health Savings Act. This bipartisan legislation would reform the Congressional Budget Office's CBO, scoring to better reflect the savings from preventive health initiatives by expanding the budgetary window the CBO evaluates.

Currently, the CBO scores the budgetary implications of legislation over a 10-year period. Oftentimes, however, the cost-savings of preventive care are not clear within the current 10-year ``scoring'' window. This legislation would direct the CBO to extend its analysis beyond the existing 10-year budget window to two additional 10-year periods, which will give a truer picture of the benefits of health initiatives and better enable Congress to pass effective policies.

Chronic and mental health conditions account for 90 percent of our Nation's $4.1 trillion in annual medical expenditures. In 2018, more than half of U.S. adults had 1 of 10 chronic conditions, and 27.2 percent had multiple chronic conditions, and this number is only expected to grow. Chronic diseases disproportionally affect racial and ethnic minorities. For example, when compared to non-Hispanic White adults, Black adults are 1.6 times, Asian American adults are 1.4 times, Hispanic adults are 1.7 times, American Indian and Alaska Native adults are 2.9 times, and Native Hawaiian and Pacific Islander adults are 2.5 times more likely to be diagnosed with diabetes. Additionally, Black adults are 1.4 times, American Indian and Alaska Native adults are 1.2 times, and Native Hawaiian and Pacific Islander adults are 1.3 times more likely to have asthma than non-Hispanic Whites.

As more Americans experience chronic conditions, the healthcare costs in the United States will continue to rise. Not only are these costs a heavy burden on millions of Americans and their families, but they are also primary drivers of our annual Federal budget deficits and accumulated debt. As medical expenditures continue to rise, it is crucial that we capture the long-term savings that can be achieved by focusing our efforts on averting, halting, or slowing preventable diseases. This is why I have long been a champion for expanded access to affordable, high-quality preventive health care and am proud to have championed initiatives from coverage for colon screenings to increased access to oral health care. But we still have progress to make.

I am encouraged by the cutting-edge research that world-class institutions in my home State of Maryland, such as the National Institutes of Health, NIH, are doing to address chronic diseases. Interventions, including screenings, vaccinations, and behavioral changes, can prevent or delay the onset of new cases and mitigate the progression of a preventable illness, which can result in large reductions in the financial, physical, and emotional toll of developing one or more chronic diseases. By having the data to enable us as lawmakers to look at cost-benefit analyses, we can most effectively use our Nation's resources to improve the health of Americans while reducing medical costs. The first step to altering the trajectory of chronic diseases and curbing healthcare costs is to have more accurate information on the cost savings of preventive care.

I thank Senators Crapo, King, and Cramer for joining me in introducing this legislation and urge my other Senate colleagues to consider cosponsoring the measure.

Madam President, today I am proud to reintroduce the Preventive Health Savings Act. This bipartisan legislation would reform the Congressional Budget Office's CBO, scoring to better reflect the savings from preventive health initiatives by expanding the budgetary window the CBO evaluates.

Currently, the CBO scores the budgetary implications of legislation over a 10-year period. Oftentimes, however, the cost-savings of preventive care are not clear within the current 10-year ``scoring'' window. This legislation would direct the CBO to extend its analysis beyond the existing 10-year budget window to two additional 10-year periods, which will give a truer picture of the benefits of health initiatives and better enable Congress to pass effective policies.

Chronic and mental health conditions account for 90 percent of our Nation's $4.1 trillion in annual medical expenditures. In 2018, more than half of U.S. adults had 1 of 10 chronic conditions, and 27.2 percent had multiple chronic conditions, and this number is only expected to grow. Chronic diseases disproportionally affect racial and ethnic minorities. For example, when compared to non-Hispanic White adults, Black adults are 1.6 times, Asian American adults are 1.4 times, Hispanic adults are 1.7 times, American Indian and Alaska Native adults are 2.9 times, and Native Hawaiian and Pacific Islander adults are 2.5 times more likely to be diagnosed with diabetes. Additionally, Black adults are 1.4 times, American Indian and Alaska Native adults are 1.2 times, and Native Hawaiian and Pacific Islander adults are 1.3 times more likely to have asthma than non-Hispanic Whites.

As more Americans experience chronic conditions, the healthcare costs in the United States will continue to rise. Not only are these costs a heavy burden on millions of Americans and their families, but they are also primary drivers of our annual Federal budget deficits and accumulated debt. As medical expenditures continue to rise, it is crucial that we capture the long-term savings that can be achieved by focusing our efforts on averting, halting, or slowing preventable diseases. This is why I have long been a champion for expanded access to affordable, high-quality preventive health care and am proud to have championed initiatives from coverage for colon screenings to increased access to oral health care. But we still have progress to make.

I am encouraged by the cutting-edge research that world-class institutions in my home State of Maryland, such as the National Institutes of Health, NIH, are doing to address chronic diseases. Interventions, including screenings, vaccinations, and behavioral changes, can prevent or delay the onset of new cases and mitigate the progression of a preventable illness, which can result in large reductions in the financial, physical, and emotional toll of developing one or more chronic diseases. By having the data to enable us as lawmakers to look at cost-benefit analyses, we can most effectively use our Nation's resources to improve the health of Americans while reducing medical costs. The first step to altering the trajectory of chronic diseases and curbing healthcare costs is to have more accurate information on the cost savings of preventive care.

I thank Senators Crapo, King, and Cramer for joining me in introducing this legislation and urge my other Senate colleagues to consider cosponsoring the measure.

Madam President, I ask unanimous consent that the text of the bill be printed in the Record.

Madam President, America must never become a safe haven for anyone who assaults the values for which this Nation stands--values like democracy, human rights, the rule of law, and the sanctity of free and fair elections.

We already deny visas to those who are human traffickers, drug traffickers, money launderers, corrupt kleptocrats, and those who commit serious violations of religious freedom. I agree with that policy. We have passed laws to allow for the prosecution in U.S. courts of anyone who has committed war crimes or used children as soldiers in deadly conflict. I have written some of those policies, and I certainly agree with them.

Today, I am introducing legislation to further align our immigration system with our values as a nation. The bill I am introducing would prevent foreign officials who interfere with democratic elections or prevent the democratic transfer of power of their country from taking refuge in the United States.

In recent years, autocrats around the world have used a toxic brew of nationalism, authoritarianism, corruption, and social media to weaken and attack the very foundations of democracy. Fortunately, democracy is winning this battle. Much of the world is unified in support of Ukraine, for example, against Putin's attempt to seize the sovereign democratic nation of Ukraine, and we have the allies in the NATO alliance and others who stand with us with strength and formidable determination to stop Putin.

In late October, the people of Brazil--the largest democracy in Latin America--chose a new President to replace the increasingly authoritarian Jair Bolsonaro. After years of baseless lies by Bolsonaro about the integrity of Brazil's elections, polls show that three- fourths of his supporters no longer trust the electoral process in Brazil.

Sound familiar?

After Bolsonaro lost in October's Presidential election, his supporters turned to violence. They blocked highways throughout Brazil. Many called openly for the military to overturn the election.

Sound familiar?

And, on January 8, as Mr. Bolsonaro took selfies with his supporters in the State of Florida, thousands of his far-right supporters violently stormed Brazil's Presidential palace, Congress, and Supreme Court--breaking windows and injuring dozens of police officers.

Sound familiar?

It was a disgrace. It was an assault on democracy--not only in Brazil but an assault on democracy everywhere.

Under the bill I am introducing, if the Secretary of State determines a foreign official has interfered with free and fair elections or has sought to prevent the peaceful, democratic transfer of power, that official cannot escape justice by fleeing to the United States.

I ask my colleagues to join in supporting this important measure to hold those who interfere with democratic elections accountable. America should never be a safe haven for enemies of democracy.