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I’m getting some worried e-mails from Hill staffers who think Senate Democrats might rubberstamp a policy House Republicans passed to undermine the Affordable Care Act. It’s the sort of policy decision that won’t get much attention but could have some very big, and very bad, effects, so let’s take a moment and go through it.

If you’ve been paying attention to the debate over the Affordable Care Act, you’ve probably heard about the 1099 provision. Essentially, small businesses manage to avoid paying taxes on a lot of small transactions. The 1099 provision would’ve forced them to report those transactions, raising about $20 billion over 10 years. But it would’ve require a lot of paperwork. So much paperwork, in fact, that Democrats agreed to repeal it.

When the Senate repealed the provision, they paid for it by canceling other spending that Congress had authorized, but that hadn’t yet been put to a particular purpose. House Republicans took a different approach. They’re trying to sharply increase the amount of subsidies that families will have to pay back if their income increases during the course of a year. The Center on Budget and Policy Priorities has a longer explanation of how this would work, but here’s the short version:

Under their proposed policy, a family with income at 225 percent of the poverty line who needed subsidies for the first half of the year but canceled them mid-year when the husband got a better job could get a bill for more than $4,500 at the end of the year.

A more worrying example goes the other way: Imagine a family where the breadwinner makes much more than 400 percent of poverty, but loses his job late in the year. He tries to apply for subsidies so the family can keep getting health insurance but is told that he shouldn’t bother — because his total income that year will still be above 400 percent of poverty, he’ll get a bill at the end of the year forcing him to pay back the money.

The Affordable Care Act, unfortunately, already includes a “payback” policy along these lines — the House Republicans are just proposing to make it much, much worse. This will do two things: make people hate the Affordable Care Act for bait-and-switching them, and keep people from entering the exchanges because they’ve heard horror stories of huge bills. It’s clear why the GOP wouldn’t mind that outcome, but there’s no reason for Democrats to accept it. The Senate should stick with the 1099 repeal that the Senate has passed.

By: Ezra Klein, Columnist-The Washington Post, March 8, 2011