Health Care For America Now

Health reform is moving into its final stages, and yet, in a sense, the process has only just begun. Here's what's happening next.

The Finance Committee will vote on the amended Baucus bill on Tuesday at 10 am. From there, Majority Leader Harry Reid will merge the Baucus bill and the late Senator Kennedy's HELP bill into one package that will go to the Senate floor. The merger will take pieces from each bill and can include the public health insurance option like the one passed in Kennedy's HELP committee, and so it is an opportunity to stand up for the principles we believe in when it comes to health reform.

When the bill goes to the floor, it will need 60 votes just to get the floor process started. Then, Senators opposed to health reform could force 60-vote motions for each amendment offered, though amendments typically only require 50 votes to pass. Here, again, is an opportunity to stand up for our principles and make the bill better. Even if amendments are offered but are not passed, we will be able to demonstrate huge support for popular provisions (progressive taxation and employer responsibility, for example) that might not be in the merged bill.

The House must go through a similar process, with Speaker Nancy Pelosi merging the three bills passed out of committee and bringing a merged bill to the floor. What exactly that merged bill will look like is still up for debate, mostly around what kind of public health insurance option the House will consider. The House process means fewer amendments and less debate than in the Senate.

Next, the bills will be voted on in both chambers. In the Senate, the bill will likely need 60 votes for cloture - a procedural vote. Lawmakers will be under pressure to vote along party lines. After cloture, the Senate bill will only need 50 votes to pass - a simple majority. The House, as well, will only need a simple majority to pass their bill.

Then House and Senate leaders will meet to iron out the differences in their bills, called a conference. Here, too, significant changes can be made to the bills, and it's an opportunity to once again stand up for our principles and push for the provisions we want to see - progressive taxation, employer responsibility, decent affordability standards, and a public health insurance option.

After conference, one bill goes back out to both houses of Congress for final votes. No further changes can be made to the bill at this point, meaning Members of Congress will have to vote yes or no, no more negotiating.

This will be a fight until the bitter end. It's unlikely any of the provisions we all feel strongly about will be considered "safe" until conference is finished and the final bill is passed. At every step of the process, we must stand up for our principles, even if we lose some battles.

We're at the beginning of a long road.