What happened to PAYGO?  ...Middle East

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Title III of the Fiscal Responsibility Act of 2023 — bipartisan legislation signed by President Biden in early June 2023 — requires that all executive actions, including the issuance of regulations and approvals of state requests whose cost exceeds $1 billion must align with “pay-as-you-go” (PAYGO) rules: that is, any increased costs to the federal budget must be met by cuts in the same amount by the relevant agency.  How is that going?  The focus of my attention and research is the work of the Social Security Administration (SSA) and the Centers for Medicare and Medicaid Services (CMS), specifically SSA’s disability insurance (DI) program and CMS’s role in providing long-term care.

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