Normally, the Senate requires a 60-vote majority to pass any legislation—a high bar that makes it hard for the Senate to quickly pass major pieces of legislation. This is intentional. It’s supposed to prevent the majority party from jamming legislation through the Senate. Budget Reconciliation, often referred to as just reconciliation, is a legislative maneuver that allows the majority to get around this 60-vote safeguard. Reconciliation lets the Senate majority bypass the filibuster process, allowing them to pass legislation with 50 votes, instead of the normal 60. This document reviews how Republicans are using reconciliation to attempt to “repeal and replace” significant elements of the Affordable Care Act.
The Reconciliation Process
Congress can only use reconciliation once for any budget they pass, and the FY17 reconciliation bill is being used to repeal the ACA. First, Congress passes a budget resolution, which specifies how much money each Congressional committee is expected to save—Congress did this in late January with instructions to repeal the ACA. Then, each of the specified committees act, and each chamber’s Budget Committee puts it all together and votes on it—that’s why the House Budget Committee held its own vote on the American Health Care Act in March. Then, the full chamber votes on the bill and it’s passed by a simple majority. In the case of AHCA, their first attempt at this phase of the process failed but prevailed by a razor-thin majority a month later. Note: Because the Constitution prohibits the Senate from originating legislation dealing with revenues, reconciliation measures generally start in the House.
Reconciliation matters the most in the Senate.
The Senate can take up a House-passed bill straight away or work its own bill through the Senate committee process. Reconciliation bills cannot be blocked through a filibuster (thus, why there is no 60-vote threshold) and have limited debate time. However, an unlimited number of amendments (as long as they don’t cost money) can be offered during that debate. When time’s up, the Senate takes a vote which requires a simple majority for passage. If changes are made to the bill, it will then go back to the House for a final vote before being sent to the President for his signature or veto.
Because reconciliation is a budget procedure, originally intended to reduce the deficit, only policy changes directly impacting government spending or taxes may be included. This restriction, known as the Byrd rule, means the entire Affordable Care Act cannot be repealed through reconciliation—only the pieces of it that directly impact government finances. Before a reconciliation bill is voted on, it goes through a “Byrd bath” (Congress can be silly) to ensure that the bill does not contain any unrelated provisions, beyond those impacting taxes or spending.
What Are Republicans Attempting to Do With Reconciliation Now?
The Senate is currently figuring out its own version of a repeal bill, but they’ll definitely use reconciliation to jam it through. It’s because of the Byrd rule that Trumpcare contains such strange provisions. Reconciliation allows the GOP to lower taxes for the rich and cut federal health aid, but it most likely does not allow them to end consumer protections, like the ban on insurance companies denying people with pre-existing conditions or mandating that health insurance covers birth control. If they want to do so, they will most likely need to pass a separate piece of legislation which is subject to the filibuster in the Senate. But would they have the votes?