One of President Trump's main campaign promises was to repeal and replace the Affordable Care Act, President Obama's signature healthcare reform. And for the last couple of months, Republicans in the U.S. House of Representatives and the Senate have been creating bills that will let Congress do exactly this. There have been some setbacks, however.
GOP Senators pretty much ignored the bill that passed in the House in early May and started from scratch. (Or at least that's what they said they would do; the Senate bill is extremely similar to the House version.) Tuesday, less than a week after the Senate's Better Care Reconciliation Act (BCRA) was made public, Senate Majority Leader Mitch McConnell announced he would postpone voting on the bill until after the July 4 recess, even though he originally planned to vote on the legislation by the end of this week.
The main reason for the delay was that McConnell doesn't have the necessary votes to move ahead with the bill. (Republicans can only afford to lose two votes to pass the reform because all Democrats have said they won't support it.) As of today, at least five GOP members have said they won't back the Better Care Reconciliation Act.
So, what happens now? Is it possible for this bill to become law?
In short, yes. We saw the House Republicans come back from an embarrassing setback in March, when they withdrew their healthcare bill because it didn't have the 216 votes needed to pass. A little over a month later, they came back with amended legislation that accommodated the majority of House Republicans, and passed it.
Will history repeat itself with the Senate healthcare bill? That remains to be seen. In the meantime, we're breaking down what happens next and what's needed for this bill to become law.
First, it will be hard to get everyone on board
From now until the day of the vote, McConnell is expected to be furiously negotiating with the GOP members opposing BCRA and those on the fence. As House Speaker Paul Ryan experienced while he was trying to pass the House bill, it's going to be a delicate dance. Giving in to the demands of hard-leaning conservatives like Sen. Rand Paul will put McConnell at risk of losing the support of moderates like Sen. Susan Collins.
Ryan had some wiggle room to reach a compromise, but McConnell's margin of error is smaller. House Republicans have a bigger majority than in the Senate, but even after all the amendments, the bill passed with 217 votes (it needed 216 to pass.)
If McConnell can't get most people on board and loses more than two votes, the Senate bill will be dead.
But if the legislation passes, it will go back to the House
If McConnell pulls it off and gets enough votes to pass the BCRA, it would go back to the House. (Some political pundits believe he can achieve this because McConnell is considered of the most savvy players in D.C.)
Once the bill goes back to the lower chamber, House Republicans would have to decide whether they want to vote on the legislation as presented or make certain amendments.
If they decide to pass the BCRA in its Senate form, it would likely be a breeze. But, there's also a possibility that the Freedom Caucus (which originally derailed the House bill and scored major amendments leading to its passage) could say that Senate version is not up to its standards. If that's the case, it would lead to negotiations between the hardline members of the House and the more moderate conservatives in the Senate.
It's highly likely that Republicans will eventually pass the bill instead of going back to the drawing board. After all, they've been promising to repeal and replace Obamacare for more than seven years.
If the bill passes the House, it will go back to the Senate, and then to President Trump's desk
If the House passes the BCRA, it would then go back to the Senate. If there are no amendments, the Senate would enroll the bill, i.e. create a final copy. If House Republicans amend the legislation and senators disagree with the changes, they would call a conference to hash out the details and decide what will go in the enrolled bill.
Either way, in the end, the final copy would be signed by Sen. Orrin Hatch, president pro tempore of the Senate, and House Speaker Ryan.
Afterwards, the bill will be sent to President Trump, who will probably will sign it into law. If this happens, the Trump administration will have chipped away one of the main legacies of President Obama, and Republicans will have won their years-long battle for healthcare reform.