Peter Orszag writes:
STATEMENT OF ADMINISTRATION POLICY: H.R. 3961 — Medicare Physician Payment Reform Act of 2009 (Rep. Dingell, D-Michigan, and 6 cosponsors):
The Administration strongly supports House passage of H.R. 3961, the Medicare Physician Payment Reform Act of 2009, and appreciates congressional efforts to ensure that Medicare beneficiaries and TRICARE patients continue to have access to care and their physician of choice. In his FY 2010 Budget, the President recognized the need for comprehensive reform for the Medicare physician payment system. The Administration believes Medicare and the country need to move toward a system in which doctors receive better incentives to provide their patients with higher quality and more efficient care.
H.R. 3961 takes additional steps to reform Medicare physician payments. The Administration is pleased that the bill would eliminate the steep payment cut scheduled for 2010. A cut of this magnitude could reduce access to physicians for Medicare beneficiaries throughout the country. The Administration also supports the provisions that provide a boost to primary care providers by increasing payments for evaluation and management services, such as office visits. H.R. 3961 would also create incentives for broader reforms for Medicare physician payments by encouraging the formation of accountable care organizations, in which groups of providers are jointly responsible for the quality and cost of health care services for beneficiaries with chronic conditions. The Administration remains committed to working with the Congress to achieve comprehensive reforms to Medicare physician payments that will enhance efficient and high-quality care for beneficiaries and protect their choice of physicians. H.R. 3961 is an important step forward in comprehensively reforming the way Medicare pays physicians to provide the very best care to the Nation’s Medicare beneficiaries and the Administration urges the Congress to pass this legislation.
The key, of course, is that although "the bill would eliminate the steep [Medicare physician] payment cut scheduled for 2010" it contains no provisions to pay for that elimination.
If Peter and company want me to use a baseline that assumes that PAYGO will hold, they need to at least whine and whimper at bills that break it.