The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Senate Finds Health Care Reform Compromise Hard to Find

Posted by Alan on November 29, 2010

Congress is in its lame-duck session. One might think that with the mid-term election completed lawmakers might have a simpler time cleaning up some of the less controversial provisions of the Patient Protection and Affordable Care Act. (“Less controversial” is a relative term, of course. There’s so little agreement on the politics and public policy concerning health care reform I’m surprised there hasn’t been a law suit filed to determine whether the issue’s should be spelled as “health care” or healthcare.”)

President Barack Obama and a majority of Senators agree that the PPACA’s requirement that 1099s must be filed by businesses (including non-profits) and by local and state governments when expenditures with a single vendor or contractor  exceeds $600 is overly burdensome and needs to be greatly modified – or better yet, repealed. Yes, there would be a cost. This provision is expected to generate $19 billion in revenues over the next decade, according to But Senators should be able to find a way to solve the problem without busting the bank, right?

Eventually, but not right now. 67 votes are required to pass an amendment stripping the 1099 requirement from the PPACA. The Senate could muster only 61 votes to save small businesses and others from the financial and administrative nightmare of preparing tax notices to Staples, Google, the local printer, the guy who waters the plants, and, well, you get the idea. 35 Senators voted against the repeal. This vote was on an amendment, offered by Senator Mike Johanns to a food-safety bill. This amendment would have also required the White House Office of Management and Budget to cut federal spending by $39 billion. Another amendment to the food-safety bill by Senator Max Baucus that did not include budget cuts failed on a 44-to-53 vote.

The New York Times reports that one reason cited by some Democrats for opposing Senator Johanns’ proposal was that it granted too much leeway to the administration to determine spending cuts. Such decisions should be made by Congress, they argued. Of course, anyone who has watched Congress over the past, say, 10 years, might question that bodies ability to cut spending on anything, but when the argument of being overly deferential to the Executive Branch is handy, some Senators will grab it. Republicans voted against Senator Baucus’ amendment because it did not offset the $19 billion in lost revenue. Given the unfunded proposals voted on by Congress with great regularity over the past, say, 10 years, that this is a sincere argument is also somewhat suspect.

The good news is that the odds are very good a compromise will be reached and the 1099 provision repealed before this Congress adjourns. At some point politics must yield to common sense and near unanimous agreement on an issue. Doesn’t it?


3 Responses to “Senate Finds Health Care Reform Compromise Hard to Find”

  1. The old saying that “common sense is not too common” applies here because it seems that Congress consistently muddies the waters by trying to pack too much into the amendments being made such that agreement is difficult to reach. There could be significantly more progress if there was more effort on steady incremental changes rather than the larger scale multifaceted amendments being made now.

  2. Dave Peters said


    You’re right — whether to use “health Care” or “healthcare” remains unsettled, however, there’s no disagreement that “lawsuit” is one word.

    Dave Peters
    Irvine, CA

  3. Alan, you said: “At some point politics must yield to common sense and near unanimous agreement on an issue. Doesn’t it?”

    Ha! It should make sense that common sense will “out”, however, having worked together “in the trenches”, we know that common sense and politics is an oxymoron. Self-preservation would seem to dictate, especially in a Senate still controlled by the Democrats, that in the self-interest just mentioned such compromise will occur before the lame-duck session ends. We can hope.

    Of course, the ability of the Members of our Congress to amend any bill with amendments unrelated to the primary tenor of the bill only heightens this ludicrous process. In Washington State, and I’d venture to say in most, if not all states, no amendments may be offered that are not germane to the primary reason for the bill that has been “dropped”. That same thinking should apply to all legislation dropped in Congress.

    Regarding the estimated $19Billion in lost anticipated revenues by doing what is right by the American Public, small businesses in specific which employ 70% of our workforce, should be of little concern to the Senators who passed HCR into law using data submitted to the CBO, admittedly skewed to provide the results desired by the Administration as stated by the CBO themselves (garbage in, garbage out). In my not humble opinion, the issue of finding another source for the $19 Billion is nothing more or less than a “red-herring”. I doubt that few Salmon would nibble it, let alone strike it. It begs credulity.

    Overall, Alan, an excellent commentary, stimulating much thought.

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