| > While I think the ACA made things better than before (it got a lot more people insured and thus no longer easily susceptible to medical bankruptcy), it was a very imperfect and inefficient solution Could they have done better? Normally a big bill like this would pass the House. Then the Senate would make several changes in order to get enough votes to pass there. Then it would go back to the House, where the House would make another round of changes...then back to the Senate, and so on. But in this case, that stopped early. It came from the House. Changes were made in the Senate that were able to get it through, 60-39 (60 were needed because Republicans were filibustering). One of those 60 was from the person temporarily filling the seat of the recently deceased Senator Kennedy. It went back to the House, and while it was there the special election to fill Kennedy's seat was held, and a Republican won, and the Democrats lost the ability to break a filibuster. So the Democrats in the House went with the bill as it came from the Senate, because that was the only thing they could pass that would not have to get past a Senate filibuster. (They were able to make some changes separately, because some of the changes they wanted, such as some relating to subsidies, because those counted as budgetary changes, and there is a separate procedure for reconciling budget changes between the House and Senate that is not subject to filibuster). Wikipedia has a good, detailed, account: https://en.wikipedia.org/wiki/Patient_Protection_and_Afforda... |