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Asking "What If Benjamin Franklin Ran the CBO?"

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During debate over health reform in 2009, we worked with Robert Wood Johnson Foundation Senior Vice President Dr. James Marks to bring attention to the Congressional Budget Office's scoring rule that excluded any returns on health investments that occur after 10 years.

Functionally, this meant that early childhood interventions and investments in early detection and prevention — all of which generally show gains well beyond the 10-year window — were not being factored into the CBO's $1 trillion projected price tag for health reform.

This POV first appeared in the Huffington Post and later in Health Affairs. A campaign developed as a result and ultimately the CBO loosened its scoring rules by projecting health reform's impact an additional 10 years, where it confirmed the cost of health care would begin to bend downward.