Key lawmakers eye off-budget account for pandemic spending

Key lawmakers on Wednesday expressed interest in creating off-budget accounts to pay for pandemic defense programs.

Doing so would allow Congress to set a budget, but then essentially go over its budget to stave off pandemics similar to the current coronavirus crisis.

Rep. Tom Cole (Okla.), the top Republican on the House Appropriations subcommittee on Labor, Health and Human Services and Education, said at a Wednesday hearing that he was “very intrigued” by the idea.

“We’re not trying to open up the budget or crack the budget caps,” he said, but added that Congress had to be flexible in the face of major events.

The accounts would be similar to Overseas Contingency Operations accounts, which Congress implemented after the Sept. 11, 2001, attacks to fund the global war on terror.

A key feature of those accounts is that they do not count toward budgetary caps set in place each year by the budget committee.

In the past decade, OCO funds also were outside legal spending caps from the Budget Control Act, which is set to expire in 2021.

Calling back to World War II, Cole noted that the defense budget and its structure needed to change significantly in the aftermath of the Pearl Harbor attacks.

“This is not a one-and-done supplemental,” he added, referring to the $3 trillion in emergency spending for the coronavirus Congress has already approved. Congress, he said, would need to consider readjusting its baseline on health spending.

“I think, honestly, spending billions to save trillions is a no-brainer to me, and I think that’s where we’re at,” he said.

Tom Frieden, the president of public health NGO Resolve to Save Lives, proposed the idea of setting up off-book, Health Defense Operations accounts during a subcommittee hearing on Wednesday.

“Other than nuclear war, there’s nothing else that can kill 10 million people around the world except a biological event, and we have to do everything in our power to prevent that from happening,” Frieden said.

Frieden said that the new health accounts would function similarly to the Overseas Contingency Operations accounts.

“It would exempt critical health protection funding from the Budget Control Act spending caps so our public health agencies can protect us,” Frieden said.

Frieden said he has submitted a letter supporting the idea to congressional leaders that had been signed by former Senate Majority Leaders Bill Frist (R-Tenn.) and Tom Daschle (D-S.D.), as well as former Centers for Disease Control and Prevention Directors Bill Foege, Jeff Koplan and David Satcher.

Budget watchers have called the OCO a gimmick and slush fund that has allowed Congress to spend freely without respecting their self-imposed spending levels.

Congress has spent over $2 trillion in the last two decades through OCO accounts, which have averaged 17 percent of total budget authority for the Defense Department, according to the Congressional Research Service.

Cole indicated that he and committee Chairwoman Rosa DeLauro (D-Conn.) had discussed the idea.