WASHINGTON, DC - House Majority Leader Steny H. Hoyer (MD) spoke on the House Floor today in support of the Medicare Physician Payment Reform Act of 2009, which will have Statutory “Pay-As-You-Go” (PAYGO) attached when it is sent to the Senate. Below are his remarks as prepared for delivery:
“Today, we have the chance to vote for health care our seniors can count on, and a fiscal future all Americans can have faith in. We can do it by stopping a massive Medicare payment cut, and by committing future policies to the tested principle of pay-as-you-go.
“First, the Medicare payment rate cut: if we do nothing, payments to doctors treating Medicare patients will drop by 21% in the new year, with more cuts in the years to come. If we allow that to take place, many seniors will find that their doctor is no longer available to treat them.
“That means less access to health care, longer waiting lists, and serious conditions going untreated—in sum, it means sicker seniors. That’s why it’s essential that we stop these cuts before they’re allowed to take effect.
“It’s important to remember that this bill would simply prevent cuts—not increase payments to doctors. But it is true that ensuring our seniors access to their doctors will add to our deficit, just as extending any of the Bush tax cuts that are set to expire next year would do. Because seniors’ health is at stake in this bill, I believe stopping the payment cuts is worth the cost.
“And it’s also worth pointing out that this bill represents a new honesty in budgeting. As far as Democrats are concerned, the days of pretending that the costs of the ‘doctor fix’ will be made up by even deeper cuts next year are over. Indeed, most of the costs associated with this bill are the result of stopping the gimmicks Republicans used for years and cleaning up the mess created by those gimmicks. The first step to getting out of debt is being honest about the debt we are in.
“So let’s be honest: our country is in a deep fiscal hole, for reasons that go far, far beyond Medicare payments. In fact, there’s no one reason for our record national debt. The causes include President Bush’s debt-financed tax cuts for America’s wealthier citizens, the cost of two wars, our escalating entitlement programs, the recession President Bush left us with, and the deficit spending we need to clean up that economic mess—spending that economists tell us is necessary to stimulate demand in a recession. A recent New York Times analysis tells us that 90% of our deficit has been brought about by the policies of the Bush administration, the extensions of its policies, and the economic crisis that it left behind.
“No one step will get us out of our fiscal hole. But the most important immediate step we can take is to commit ourselves to the principle that, in new policies, our country will pay for what it buys. That is the principle of pay-as-you-go, or paygo—and it is a proven tool for fighting debt.
“In the 1990s, President Clinton used it to turn huge Republican deficits into a record surplus; and when President Bush abandoned paygo, record deficits returned. When Democrats took back the House majority in 2006, we demonstrated our commitment to fiscal responsibility by making paygo part of the House rules. And now, with support from President Obama and both chambers of Congress, we have a real chance to give paygo the force of law by passing this bill.
“Under paygo, Congress will be forced to offset all new policies reducing revenues or expanding entitlements, so that they add nothing to our deficit. In essence, we will be forced to make the hard budgeting choices that are so tempting to avoid—to stop politically painless giveaways financed with borrowed money. If we want to cut taxes, we’ll have to explain which programs will suffer cuts. If we want to expand entitlements, we’ll have to spell out how to pay for it. And no matter which party is in power, we’ll be forced to distinguish wasteful spending and subsidies from the long-term priorities that really matter to our country.
“Some have complained that statutory paygo would not apply to extensions of some existing policies that have bipartisan support: policies on the Alternative Minimum Tax, Medicare doctor payments, and the estate and middle-income tax cuts passed in 2001 and 2003. I sympathize with their concerns, and I have said repeatedly that I would fight to pay for all of those policies. That stands in contrast to President Bush and Congressional Republicans, who have repeatedly stated that they do not believe that extensions of tax cuts need to be paid for. Unfortunately, it’s a political reality that the votes to pay for extensions of the bush policies are most likely not there. A paygo law that ignored that fact would be waived for those polices, and then again and again. I prefer a law that we can enforce consistently.
“Mr. Speaker, in our country’s economic meltdown last year, we all saw the damage that deep debt can do. It’s time for our federal government to learn that lesson, and act on it. If we fail to act, liberal and conservative, Democratic and Republican, priorities will suffer alike.
“We can still prevent that outcome. We cannot get back to fiscal health in one afternoon’s vote—but we can start here. I urge all of my colleagues to join me in voting for this bill.”