Policy Corner: Senate Health Care Bill Includes Healthy Lifestyle Provisions

Last week, Senate Majority Leader Harry Reid (D-NV) unveiled a sweeping health care bill that would expand health insurance coverage to 30 million more Americans at an estimated cost of $849 billion over 10 years. The Congressional Budget Office (CBO), which is the nonpartisan entity charged with analyzing the cost of proposed legislation, estimated that the proposal would reduce the federal deficit by $127 billion over the next 10 years and by more than $600 billion in the following decade. ACSM was pleased to learn that the bill includes prevention and wellness provisions that are supported by Democrats and Republicans alike, including establishing a Prevention and Public Health fund, which would be funded at nearly $5 billion over five years and authorizes the creation of community-based prevention and wellness programs to promote healthy lifestyles, including increased physical activity levels.

The 2,074-page Senate bill seeks to reduce long-term costs of health care for the government, businesses and individuals while reforming how services are delivered to increase efficiency and effectiveness. It includes controversial provisions such as a government-run public health insurance option unanimously opposed by Republicans. However, the bill mandates that Medicare beneficiaries receive an Annual Wellness Visit, which includes a personalized prevention plan, and requests that the Secretary of the Department of Health and Human Services evaluate the available evidence, literature, best practices, and resources that are relevant to programs that promote healthy lifestyles and reduce risk factors for the Medicare population.

Finally, the bill includes a Sense of the Congress statement that encourages Congress to work with the CBO to develop better methodologies for scoring progress to be made in prevention and wellness programs. CBO has been criticized for not recognizing the health care cost savings that are associated with healthy lifestyles.

As a major champion of prevention and wellness provisions, Senator Tom Harkin (D-IA) stated after the release of the Senate bill that a major focus was to “put more emphasis on keeping people healthy rather than just going to the hospital and fixing them up. And I think this is one of the most important parts of this bill…to start focusing on a health care system rather than a sick care system, which is what we have right now.”

The Senate plans to begin debate on the bill, which is expected to take weeks to complete, when it returns from the Thanksgiving weekend break. If the Senate manages to pass a bill, a congressional conference committee would need to merge the House and Senate proposals into a consensus version requiring final approval from each chamber before moving to President Obama's desk to be signed into law.