How ObamaCare Became Law, Version 1

Did the Democrats pass Obamacare using Budget Reconciliation?

Answer: NO and YES.

Here is what happened.  After a year of deliberation and wrangling, the Democratic-controlled House and Senate each passed a different version of health care reform in 2009.  On November 7, the House passed its version of the bill on a 220-to-215 vote. On December 23, the Senate voted 60 to 39 to end debate on the bill, eliminating the possibility of a filibuster by opponents. The bill then passed on a party-line vote of 60 to 39 the next day. 

Soon after the Senate passed the Affordable Care Act, Scott Brown was elected to take Ted Kennedy’s seat and the Democrats consequently lost their filibuster proof 60 votes in the Senate. Consequently, the most viable option for the proponents of comprehensive reform was for the House to abandon its own health reform bill, and instead approve the Senate-passed bill.  They knew they could not get an amended bill passed by the Senate since they would not have 60 votes to end a Republican filibuster.  However, a number of House Democrats who had reluctantly backed the president on health care reform didn’t like a number of provisions in the Senate version of the bill such as a provision that would have provided a higher rate of Medicaid reimbursements for Nebraska – the so-called “Cornhusker Kickback” that was designed to win the support of Democratic senator Ben Nelson of Nebraska.

House Speaker Pelosi made a deal to get the reluctant Democrats to go along with passing the Senate version of the bill.  If they would vote for the Senate bill, then the Democratic leadership agreed to immediately introduce and pass separate legislation under Budget Reconciliation amending the Affordable Care Act to address those members’ grievances.  The House passed the Senate bill on March 21, 2010 by a vote of 219 to 212.  The Patient Protection and Affordable Care Act was signed into law by Obama on March 23, 2010.  

Pelosi then introduced the Health Care and Education Reconciliation Act of 2010

to make changes to the Affordable Care Act. The Democrats used reconciliation to pass the amendments. On March 26, 2010, the Senate approved the amendments, 56 to 43, and the House passed them, 220 to 207.  Obama signed the Health Care and Education Reconciliation Act of 2010 into law on March 30, 2010.

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