Healthcare Bills: Laws' Journey Explained

The process of a healthcare bill becoming a law is a complex one. In the United States, the idea for a bill can come from a sitting member of the U.S. Senate or House of Representatives, or it can be proposed during their election campaign. Bills can also be petitioned by citizens or groups who recommend a new or amended law to their Congressional representative. Once introduced, a bill is assigned to a committee, which will research, discuss, and make changes to it. The bill is then put before the chamber to be voted on. If it passes one body of Congress, it goes through a similar process in the other body. Once both bodies vote to accept a bill, they must work out any differences between the two versions, and then both chambers vote on the same version of the bill. If it passes, they present it to the president. The president can approve the bill and sign it into law, or they can veto it. If the president chooses to veto, Congress can override that veto, and the bill becomes a law.

The bill must be introduced

The process of a healthcare bill becoming a law begins with the introduction of the bill. This can happen in a few ways. The idea for a bill can come from a sitting member of the U.S. Senate or House of Representatives or be proposed during their election campaign. Bills can also be petitioned by citizens or citizen groups who recommend a new or amended law to a member of Congress that represents them.

Once the bill is introduced, it is assigned a number and sent to the relevant committees for review. These committees will research, discuss, and make changes to the bill. The committees that receive the bill differ depending on the subject of the bill. For example, a healthcare bill may be sent to the Ways and Means Committee, which is responsible for writing new tax legislation, the Energy and Commerce Committee, which regulates the insurance industry, and the Budget Committee, which decides what the government can tax and spend.

While the committees review the bill, they hold hearings with experts to better understand the potential impact of the bill. After the hearings, committee members debate and propose amendments to the bill. The last step for the committees is voting on whether to accept all the changes they made during the mark-ups.

Each committee has three options: send the bill to a subcommittee for further debate, send it to the whole House for a vote, or “table” the bill, meaning it will not leave the committee. Bills that are tabled are usually not reintroduced until the next Congress.

When the bill reaches the floor of the House, it is accompanied by reports explaining why the committees recommended passage. Then, the full body of the House debates and proposes amendments. The House Rules Committee sets the terms of the debate, including time limits and which amendments are offered. Each amendment is considered separately and subject to its own vote.

Next Steps

Once the debate is over, there is a roll call vote. If the bill passes, the House sends the final version to the Senate. The Senate's processes are very similar to those of the House. When the Senate receives the House bill, Senators decide whether to send the bill to a committee or offer their own version.

The bill must pass the House

For a healthcare bill to become a law, it must first be introduced in the House of Representatives of the Legislative Branch (Congress). Once introduced, the bill is assigned a number and referred to several committees, including the Ways and Means Committee, the Energy and Commerce Committee, and the Budget Committee. These committees are responsible for researching, discussing, and making changes to the bill.

During the committee review process, hearings are held, which involve interviewing individuals with expertise in the subject matter of the bill. After the hearings, committee members debate and propose amendments to the bill. The committees then vote on whether to accept the proposed changes.

Each committee has three options: send the bill to a subcommittee for further debate, send it to the whole House for a vote, or "table" the bill, meaning it will not leave the committee. If the bill reaches the floor of the House, it is accompanied by reports explaining why the committees recommended its passage. The full House then debates and proposes amendments, with the House Rules Committee setting the terms of the debate, including time limits and which amendments are offered.

Once the debate is over, a roll call vote is held. If the bill passes, the House sends the final version to the Senate.

The Senate must pass the bill

In the case of a healthcare bill, it must be introduced in the House of Representatives of the Legislative Branch (Congress) because it includes sections that raise taxes. This falls under Article I, Section 7, Clause 1 of the Constitution, the Origination Clause, which states, "All Bills for raising Revenue shall originate in the House of Representatives; but the Senate may propose or concur with Amendments as on other Bills."

Once the bill has been introduced and assigned a number, it is referred to specific committees, such as the Ways and Means Committee, the Energy and Commerce Committee, and the Budget Committee, which will review, hold hearings, and propose amendments. The bill is then voted on by the full body of the House, and if passed, it is sent to the Senate.

The Senate's processes are similar to those of the House. When the Senate receives the bill, Senators decide whether to send it to a committee or offer their own version. The bill is then reviewed by the appropriate committees, which may include the Finance Committee and the Health, Education, Labor, and Pensions (HELP) Committee. The bill undergoes hearings, debates, mark-ups, and committee votes before being reported for floor action, where Senators can debate and offer amendments.

For a healthcare bill to pass the Senate, it must go through these committee processes, floor action, and a final vote. If the bill passes in the Senate, it will then be sent back to the House if there are any amendments or differences between the two versions. The two chambers must work together to reach a compromise and pass the same version of the bill.

The President must sign the bill

Once a bill has been passed by both chambers of Congress, it is presented to the President for approval. The President can then choose to approve the bill and sign it into law. If the President approves the bill, it becomes law immediately, and the relevant agencies begin writing and adopting regulations and policies necessary to enforce the new law.

If the President does not approve of the bill, they can veto it. If the President vetoes the bill, it is sent back to Congress, which can then attempt to override the veto. To override a veto, Congress needs a two-thirds supermajority vote in both the House and the Senate. If Congress achieves this, the bill becomes a law.

However, if the President does not sign off on a bill and it remains unsigned when Congress is no longer in session, the bill will be vetoed by default. This is called a pocket veto and cannot be overridden by Congress.

The bill must be implemented

Once a healthcare bill has been passed by Congress and signed into law by the President, it must be implemented. This is when the real work begins, as the bill's provisions are put into action and its effects are felt by the public. Here are some key steps and considerations in implementing a healthcare bill:

• Funding: Healthcare legislation often includes sections that raise taxes to pay for additional coverage and administration of the new laws. It is crucial to ensure that the necessary funds are available to carry out the provisions of the bill effectively.
• Agency Involvement: The implementation process involves various government agencies that are responsible for enforcing the new law. These agencies play a critical role in translating the bill's provisions into concrete policies and procedures. They may also provide advice and expertise during the implementation process.
• Regulation Development: The relevant agencies will develop regulations, policies, and guidelines to ensure the law is applied consistently and effectively. This process may involve public input and feedback to ensure that the regulations are fair and practical.
• Training and Education: Implementing a new healthcare bill may require training and education for healthcare providers, administrators, and the public. This ensures that everyone understands the new law and can adapt to any changes in policies, procedures, or coverage.
• Monitoring and Evaluation: The implementation process should include mechanisms for monitoring and evaluating the effectiveness of the new law. This may involve collecting data, conducting surveys, and analyzing the impact of the bill on access to healthcare, costs, and health outcomes.
• Flexibility and Adaptation: The implementation process should allow for flexibility and adaptation. As the bill is put into practice, there may be unforeseen challenges or issues that require adjustments to the original plan. Regular evaluation and feedback can help identify areas that need improvement or modification.
• Collaboration: Effective implementation requires collaboration between different levels of government, agencies, healthcare providers, and stakeholders. Open communication and coordination can help ensure that the bill is implemented smoothly and consistently across the healthcare system.
• Timeline: The implementation of a healthcare bill may occur in phases or stages, with certain provisions taking effect immediately while others are implemented gradually. A clear timeline and milestones can help ensure that the process stays on track and that key stakeholders are aware of their responsibilities.

Frequently asked questions