President Obama asked Congress to approve legislation requiring that any new tax cut or entitlement program be offset by payment reductions or revenue increases, a policy commonly known as PayGo, while explicitly exempting Medicare payments for doctors from the new rules.

Specifically, the president has proposed putting PayGo into law, with automatic cuts in mandatory programs as penalties for violations. (The House and Senate adopted pay-as-you-go rules in 2007, but their effectiveness is limited without an enforcement mechanism.) Four areas were cited as exceptions because current policy differs substantially from current law, including Medicare payments to physicians. The AMA issued a statement supporting this recognition that permanent Medicare physician payment reform must be included in any health system reform legislation enacted this year.


Publication Date: Wednesday, August 12, 2009