Health Care for America NOW

Steps To Win

On this page:

The Lay of the Land: The Structure of Congress

CURRENT STEP - Step 5: House & Senate Bills Reconciled and Passed

Where We Are Now

Where We Are Going

What You Can Do To Help

Winning quality, affordable health care for all is about more than having the right principles. You need a plan to win. Here's how Health Care for America Now is going to do it, step by step.

The Lay of the Land

First, let's take a look at the structure of Congress. There are specific committees in both the House and the Senate that have jurisdiction over health care reform, and therefore will play a big role in the process. The members of these committees - their Democratic chairs, the ranking Republican members, and general membership - will all be key players. This explains our focus - both now and in the future - on these Members of Congress.

Mouse over the graphic below to view the members of each of the primary committees of jurisdiction in both the House and the Senate, as well as an outline of the basic process by which a health care bill may become law. (Note: Committee assignments have not been finalized for the 111th Congress, so some of the information below will change.)

(Print a version of this chart for easy reference)

Steps To Win

Broadly speaking, the legislative process moves in identifiable steps. Though the specifics, timing, and sequencing will change (such as skipping a subcommittee or full committee), we know generally what is going to happen and what we will need to do at each step to make health care reform a reality. The key at this point is to prepare for possible legislative scenarios rather than be too focused on predicting what route the legislation will ultimately move through.

Below is a chart showing where we are in the process (highlighted in red), where we've been, and where we are going. Some of these steps may ultimately overlap or the House or Senate may move through the process first, with the other legislative body following. Click on each step for more detailed information on what may take place in each step and what we need to do to move quality, affordable health care for all forward.

Steps To Win
Initial proposals
Hearings / draft legislation
Committees pass legislation
Congress passes legislation
House & Senate bills reconciled & passed
President signs bill into law

Completed Steps

Click on each completed step to see where we've been and what we've accomplished towards our goal of winning quality, affordable health care for all.

Step 1: Initial Proposals

Step 2: Committees Hold Hearings/Draft Legislation

Step 3: Committees Pass Legislation

Step 4: Congress Passes Legislation

CURRENT STEP - Step 5: House & Senate Bills Reconciled & Passed

Overview of the Process

The House and Senate have passed different versions of a health care bill. Now, these bills will go through a process called a "conference," where they will reconcile the different pieces of legislation into one bill. That one bill will then go back to the House and to the Senate for final passage. If the legislation is modified in the next round of votes by the House or the Senate, the alternate body will then need to vote on the amended legislation (or a subsequent conference will need to be held). Alternatively, one body could amend the other one's bill and then pass it, sending it back to the first body for final passage.

In another formulation of the process, one House of Congress could pass a set of "fixes" to their or the other Houses's bill. For example, the House could pass fixes to the Senate bill, send those fixes to the Senate for approval, after which the House would approve the original Senate health care bill and send both bills to the President's desk for signatures.

The legislation will need a majority of support in each house to pass, and the final bill would be subject to a filibuster in the Senate if it is moved through "regular order," which means 60 votes will be needed to cut off debate and proceed, but would not be subject to a filibuster if the Senate uses the "budget reconciliation" process to pass a bill.

Where We Are Now

The House of Representatives passed their health care bill on Novermber 7th, 2009 with a vote of 220-215 (roll call, full bill). The bill has the choice of a public health insurance option, tax credits to make health care affordable, asks employers to pitch in their fair share, and covers 96% of Americans according to the CBO (5 million more than the Senate bill). This is the first time in our country's history that the House has passed a comprehensive health care bill. (You can find out how your Representative voted by clicking here.)

Two amendments were offered in the House, a Republican substitute amendment which failed to pass, 176-258 (roll call), and an amendment offered by Congressman Stupak (D-MI) which would prohibit any health care plan in the new Exchange from offering abortion coverage. The Stupak amendment passed, 240-194 (roll call).

Similarly, the Senate passed their health care bill on December 24th, 2009 with a vote of 60-39 (roll call, full bill). The bill lacks a public health insurance option, doesn't provide enough tax credits to make health care affordable for low- and moderate-income families, taxes health benefits to pay for reform, and doesn't ask employers to cover employees with good health insurance. It covers 94% of Americans according to the CBO.

Where We Are Going

The House and Senate bills are heading into "conference," where their differences will be worked out. It is likely that there won't be a formal conference. Instead, Speaker of the House Nancy Pelosi, Majority Leader Harry Reid, and President Obama will work together to hash out differences. The House will likely pass the Senate health care bill and a package of improvements at the same time, allowing the Senate to pass the improvements using the budget reconciliation process (which is not subject to a filibuster or cloture and requires only a simple up-or-down vote in the Senate to pass). The House may schedule its vote for as soon as the week of March 15th.

If each house approves the final bill, it will then be sent to President Obama for his signature. We expect this step to be completed by the end of March or early April.

What You Can Do To Help

We will need all the tools in our arsenal to ensure the Health Care for America Now principles make it into the final, reconciled bill and that this bill passes both the House and the Senate. Our efforts are focused around our letter, which outlines what we need to see in a final bill. Here's how you can help:

Call your Representative - The House may vote as soon as the week of March 15th. Call your Representative and urge them to vote YES.
Sign the letter - Join national organizations, experts, and thousands of grassroots supporters. Sign the letter asking for changes and send it to President Obama, Speaker Pelosi, and Majority Leader Reid.
Call Congress - Congress must get the message that we need to finish reform, finish it right, and finish it now. Call them to tell them today!
Forward the letter to friends - It's crucial that leaders in Congress and the President hear from as many people as possible about the changes that must be made.
Donate to the campaign - We're raising money to put an ad on the air pressuring Congress and the President to finish reform right and make the changes we need.
Volunteer in your state - Health Care for America Now has grassroots offices in 42 states and grassroots supporters in all 50. Get involved in the effort in your state and in your community to help us pressure Congress and win quality, affordable health care for all in 2009.