Watching C-Span? Here’s How to Follow the Senate Health Care Debate

The 20 hours may not be consecutive. During past reconciliation bills, the Senate has taken recesses during the evenings. Either side can voluntarily give up some of its time if it wants to.


Under the budget rules, senators can bring an unlimited number of amendments to the bill, as long as they are “germane” and would not add to the budget deficit. These can be brought by Republicans or Democrats. Various versions of the health legislation are floating around, as well as competing proposals from Republicans from various camps. Those are likely to be considered. But so are amendments from the minority side. Democrats are likely to force their Republican colleagues to go on the record making as many tough votes on health care policy as they can.

Unlimited isn’t really unlimited, of course, since the senators do have to stick around and vote on them, and they will need to sleep eventually. Since the 1980s, the average reconciliation bill has involved 22 roll call votes on amendments. The bill with the most amendments, the Balanced Budget Act of 1995, involved 51 roll call votes.


The Ohio Clock near the Senate floor. It typically takes an average of three days for a reconciliation bill to make its way to a final vote.

Al Drago/The New York Times

Still, expect this vote-a-rama, as it’s frequently called, to go all night and into the early morning once it begins.

Mr. McConnell can pull the bill from the floor at any time. If the bill proceeds to the vote-a-rama, experts say that’s a good sign that he thinks he can pass the bill.

Points of order

There are various other Senate rules, as well as special rules governing the reconciliation process. A senator who believes that a rule has been broken can raise a “point of order.” The Senate’s parliamentarian, a staffer who is an expert on rules, will advise on the issue. Traditionally, the parliamentarian’s advice is followed.

The parliamentarian, Elizabeth MacDonough, has already offered some preliminary opinions on parts of a draft bill, and has found that several provisions violate budget rules and should not be included in a reconciliation bill. If those provisions end up in amendments, expect senators to raise points of order. (There are also important questions that she has not yet considered, and those are also likely to be raised.)

Substitute amendment

Mr. McConnell may offer the very last amendment of all, an amendment meant to substitute for all the others. So far, he has not said which version of the Republican health legislation he favors, but this is likely to be the moment where he reveals his preference. (That preference, of course, may be shaped by the earlier votes.)

The Senate would vote on this amendment to replace the others. If it fails, the bill is unlikely to become law.

Final passage

This is the vote you would expect, in which the full Senate votes on a final piece of legislation. Republicans control 52 seats, but under the reconciliation rules in this case, they need only 50 votes for passage. Vice President Mike Pence can serve as a tiebreaker, and he is expected to support any bill that makes it this far.

But wait, there’s more

Once all that is over, the bill has still only passed the Senate. The House will need to either pass the Senate’s version, or the two bodies will need to reach consensus on a compromise bill, which both sides will have to pass again.

Any legislation that passes both chambers will also need to be signed by President Trump before it becomes law.

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