Urgent: A Critical Understanding of Healthcare Bill Procedures

Dear friends,

We’ve been hearing a lot about the proposed healthcare bill.  The toll it will take on millions of Americans, in particular, those of us affected by autism and other disabilities.  I’m not going to get into the specifics of what the bill entails because you probably are keeping up with those details yourself.

Politics are confusing, and it’s easy to stay out of it (kind of like not talking about it at the dinner table).  And now, more than ever, it’s important that we speak up NOW because this is a reconciliation bill* meaning there are a lot of rules that differ from the normal legislative process and have some pretty important implications.

You already know which parts of the bill are unacceptable, and I don’t want you to think I’m downplaying them at all.  That is not at all the case.  But I think it’s important that you understand why it is so critical that you reach out to your Senators today (and tomorrow, and the next day…).

  1. Senators have only 20 hours total to debate and vote.

Over the next couple of days, several amendments will be brought to the Senate floor to be heard.  Unfortunately, during this time, when an amendment is presented, Senators will only have a few minutes for debate/ discussion before the amendment is called for a vote.  This doesn’t give anyone much time to really consider the amendment before moving onto the next one, making it hard to keep track of how one amendment might affect the overall bill.

  1. Amendments must be directly relevant to the bill (tax, spending, debt limit adjustments, etc).

Senators who want seemingly less important things added to the bill could get their amendments added, leaving the bill with some unexpected “extras.”

  1. A simple majority is needed for the bill to pass.

Most legislation can filibuster and need 60 votes to end that. But, a reconciliation bill only needs 50 votes and Vice President will break the tie (and presumably, VP Pence will vote in favor of the bill).

  1. The Congressional Budget Office (CBO**), will not provide any fiscal or economic analysis on the final bill before it’s voted on.

The score released on Monday is the only financial or economic analysis for this bill during this period.  Considering how fast the amendments will be approved, how little debate will take place, and how short the timeframe for completing this process is, there will not be enough time for the Senators to fully understand the economic and fiscal impact the amendments will have on the final bill.

The last objective impact analysis is what they received from the CBO on Monday.  Each new amendment will change the amount of the impact. So…Senators will vote on a bill without actually knowing the fiscal or economic bearing of the new amendments – how many people will lose their essential health benefits, access to Medicaid, the impact of lower quality healthcare, employment, and all of the other ways this will affect the lives of millions of people.

Here’s the bottom line:  Smart people don’t make decisions without all of the information.  Business people don’t broker deals without doing an analysis.  Congressmen should not pass bills without the facts about how their votes impact their constituents.

We need to help Senators understand that while they might have their opinions about why they support the bill, without any financial / economic analysis, they won’t be making a truly informed decision as they vote this week. 

It isn’t ok for this bill (or any other bill) to be passed without all of the information; specifically, without completely understanding how the amendments, and ultimately the final bill, will impact millions of people. Without input from the CBO, passing this bill is like buying a car, sight unseen.

Remember, you are more than JUST one person.  You have a voice, and your voice carries to your friends and family.  Your voice carries across state lines. Your voice can carry a logical message to people who don’t see eye-to-eye with you on other topics.

Please call Senator Todd Young’s Indiana and DC offices and say something like (of course, you can add all of the other concerns too!):

“Will you commit to not vote for this bill until you have all of the relevant information, including the economic and fiscal analysis?”    

“I urge you to vote against this bill until you have all of the economic and financial details.”

Then, pass your message along to your people and ask them to pass it along to theirs.  Talk about it.  Facebook and Tweet about it.  Share other people’s messages.  Your reach is broader than you might think.

Let us know how it goes or if you have other thoughts or suggestions. We are working together at the state and national level to ensure that all people affected by autism have access to the supports and services they need to ensure the best outcomes and the highest quality of life.

As always, yours from the trenches,

Dana Renay

Chief Executive Ally


Senator Todd Young Contact Information:

Follow this link to send an email.


400 Russell Senate Office Building
Washington, DC 20510
Phone (202) 224-5623


46 East Ohio Street
Suite 462
Indianapolis, IN 46204
Phone 317-226-6700
Office hours 8:30am – 5:00pm

New Albany
3602 Northgate Court
Suite 15
New Albany, IN  47150
Phone 812-542-4820
Office hours 8:30am – 5:00pm

101 Martin Luther King Jr. Blvd
Suite 110
Evansville, IN  47708
Appointments are required for service at this location
Fort Wayne
1300 South Harrison Street
Suite # 3161
Fort Wayne, IN  46802
Appointments are required for service at this location


*Reconciliation is a legislative process specifically to prevent filibuster (a way to basically stop/slow down a vote by using a lot of time presenting information) during the passage of a budget bill. It is for the Senate, but the House of Representatives can also have these types of bills (although they don’t use it very often).  Reconciliation was first used in 1980 and allows tax, spending, and debt limit adjustments


**The Congressional Budgetary Office (a.k.a CBO) provides a non-partisan analysis of budgetary and economic issues, like how this bill will affect the overall economy, which is used by members of Congress when working on and voting for bills.  They don’t make any recommendations, they just provide financial information and cost estimates for proposed legislation.  They are a big deal though!  And, because many of you have probably have read more about them today than I have…I’ll leave it at that!

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