Not quite a year old, the Patient Protection and Affordable Care Act continues to draw controversy in Washington, where last week Senate Republicans tried to repeal the law and also place a moratorium on future efforts to implement it.
Fight over ACA not over
Senate votes to repeal unpopular 1099 provision
Their counterparts in the House, meanwhile, were busy investigating how HHS is spending federal dollars to implement the 2010 law. The Senate also voted to eliminate an unpopular 1099 reporting requirement and debated whether the law is constitutional, two days after a federal judge said it's not.
As expected, Senate Republicans came up short in a Feb. 2 vote on a repeal amendment that would have been attached to an air traffic control modernization and safety bill. Sen. Joseph Lieberman (I-Conn.) and Sen. Mark Warner (D-Va.) did not vote on the measure, which was defeated 47-51.
“The Senate Republicans promised the American people we would vote to repeal Obamacare, and we have done that,” Senate Minority Leader Mitch McConnell (R-Ky.) said in a video on his website. “But this fight isn't over.”
The Senate did, however, strongly support an amendment from Sen. Debbie Stabenow (D-Mich.) to repeal the 1099 provision, which lawyer Amy Gordon referred to as “universally hated.” That condition would have required businesses to file a form with the Internal Revenue Service for every vendor with which they had conducted a transaction worth $600.
Gordon, a partner in McDermott, Will & Emery, said many employers feared their third-party administrators would have been required to prepare many more 1099 forms, which would have driven up fees.
The repeal of the 1099 provision, which still requires action in the House, has also been a significant concern for physician practices. “They are going to be pleased when they understand it's going to go away,” said Patrick Smith, vice president of government affairs at the Medical Group Management Association.
Dr. Cecil Wilson, president of the American Medical Association, in a statement, called the provision “unnecessary and burdensome,” and added that AMA estimates that paperwork already takes up as much of a third of a physician's workday.
Hours before the Senate votes took place, the Senate Judiciary Committee held the first congressional hearing to examine the constitutionality of the Affordable Care Act. Assistant Senate Majority Leader Dick Durbin
(D-Ill.), who chaired the hearing, noted that three other major laws were invalidated by lower courts before they were ultimately upheld by the Supreme Court: the Social Security Act, the Civil Rights Act of 1964 and the federal minimum wage law. And Sen. Kay Bailey Hutchison (R-Texas) introduced a bill Friday that would delay provisions and new regulations of the Affordable Care Act not in effect on the date of enactment until there is a final resolution regarding the court cases. The bill would not suspend the provisions of the bill that are already in effect.
Meanwhile, the House Energy and Commerce Committee sent two letters last week to HHS Secretary Kathleen Sebelius requesting information about the agency's use of taxpayer dollars, including federal funding to implement the Affordable Care Act. The committee, led by Chairman Fred Upton (R-Mich.), asked HHS how it will spend $1 billion for the new Health Insurance Reform Implementation Fund—which was appropriated in last year's Health Care and Education Reconciliation Act of 2010—as well as $400 million allocated in the 2009 stimulus bill for comparative effectiveness research.
Rep. Henry Waxman (D-Calif.), the committee's former chairman and current ranking member, responded in a letter to Upton calling some of the committee's requests “unduly disruptive,” taking particular issue with the one targeting the Implementation Fund.
“There have been no claims that this fund has been used improperly,” Waxman wrote, “yet you request an entire agency to produce deliberative budgetary information and internal communications.”
Upton fired back that the Democratic majority in the previous Congress did not hold a single hearing in the Oversight and Investigations subcommittee on either the effects or implementation of the Affordable Care Act.
“Last year, the Democratic majority opted to place HHS in charge of the healthcare of every single American,” Upton wrote. “If the HHS bureaucracy can handle monitoring every doctor and patient relationship in the United States, it can handle a simple request for documents from an American public hungering to finally know the details about the administration's healthcare takeover.”
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