Health Care Reform Bill Passes House. Now What?
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Health Care Reform Bill Passes House. Now What?

May 15 2017

The U.S. House of Representatives recently passed legislation to repeal and replace the Affordable Care Act (ACA).

But there’s still a long way to go for the American Health Care Act (AHCA) to become law. Following its passage in the House on Thursday, May 4, the AHCA now heads to the U.S. Senate, where it is expected to face changes as well as procedural hurdles before it can go up for a vote.

Here are the next steps for the bill as it makes its way through the legislative process:

9789D - Health bill into law infographic_v6

Senate writes its own version of the bill – Because the AHCA was approved under the budget reconciliation process, it will need to comply with Senate rules so it can pass with 51 votes instead of having to meet the normal 60-vote threshold to avoid a filibuster.

Senate referee decides – In order to pass legislation through reconciliation, the Senate parliamentarian will need to determine whether the bill clears the “Byrd rule” that requires all provisions to be budget related and also stipulates that the bill cannot add to the deficit in the long term (10 years after taking effect).

Senate votes – If the bill complies with special budget rules, it will then move to the Senate floor for a full vote. With a 52-48 majority, Senate Republicans have a thin margin for error. The bill only needs 51 votes to pass the Senate under reconciliation rules and the vice president (who also serves as the president of the Senate) could be called in to break a tie.

House and Senate work out differences – If, as expected, the Senate bill is not identical to the AHCA that passed the House, a conference committee will be formed. This group of lawmakers from the two chambers that will iron out the differences between the bills, which are then presented in one combined bill to both chambers for a final up-or-down vote.

White House approval – If both the House and Senate approve, the bill is sent to the White House where the president is expected to sign it into law.

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