On Tuesday, Vice President Mike Pence stepped in to break a 50-50 tie vote in the Senate, allowing debate on health care reform to move forward.
Now what happens?
Here’s how the week will play out, according to lawmakers we spoke with on the Hill. (All of this, of course, with the caution that this is a highly fluid, if not unstable, legislative situation).
WHICH BILL WILL THE SENATE DEBATE?
The Senate will return to the House-passed bill, The American Health Care Act or ACHA. You can read the CBO’s full assessment of the legislation here.
WHAT ARE THE KEY AMENDMENTS?
There will be some early motions for amendments:
- Lawmakers will put forward some version of the Senate-passed bill, the Better Care Reconciliation Act (BCRA). Which of those versions depends on a secondary vote, which would seek to amend THAT bill with plans from Sens. Ted Cruz and Rob Portman on market regulation and Medicaid, respectively. (An amendment would likely be hybrid of those plans, incorporating the Cruz amendments and adding more money for states to stabilize their health insurance markets).
- Several lawmakers are also expected to put forward a straight repeal.
Both amendments are expected to fail.
WHAT OTHER AMENDMENTS WILL COME UP?
There will be scores — possibly hundreds — of amendments to the bill. Any senator can offer one. A flurry of votes known on Capitol Hill as a “voterama” will be the last step before final passage and could last many hours or a even a whole day. Note: Debate is not required on amendments, though Republicans may allow it if they choose.
HOW MANY VOTES WILL THE BILL NEED?
- Most amendments will require 60 votes. This is because most amendments will not have a CBO score yet. Without a score, any senator can raise a point of order against an amendment. It takes 60 votes to override such a point of order. This will potentially apply to the big amendments, like the BCRA/Cruz amendment and the straight repeal (depending on how lawmakers do that).
- Sen. John Thune, R-S.D., told some of us Tuesday that he is hoping for scores on most amendments, but in truth, it seems most amendments will not get scores.
- This is a key issue, particularly for the “skinny,” or partial, repeal, which among other things would get rid of penalties both for individuals who choose to go without insurance and companies who choose not to offer it. Senators will need to put forward amendments that can pass the Byrd rule and be scored.
WHEN WILL ALL OF THIS HAPPEN?
- The motion to start debate requires 20 hours of debate on the underlying bill.
- Democrats can waive that if they choose — or they can add to it (as I suspect they will do), requiring things like the bill being read out loud in its entirety. Such procedural motions do not count for debate time.
WHAT ELSE DO WE KNOW?
- It is going to be a long week, likely with overnight sessions.
- It’s utterly unclear how the GOP will craft a bill that can get 50 votes. But these next two to three days are their chance.
- Twitter, we suspect, will have a very good week.