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Congress: the institution. How a bill becomes a law. Introduced by a member in either chamber House.gov Referral to the committee (s) with jurisdiction Committee assignments and makeup Committee (and subcommittee) chairs After referral to subcommittee Into the Garbage can Hearings
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How a bill becomes a law • Introduced by a member in either chamber • House.gov • Referral to the committee(s) with jurisdiction • Committee assignments and makeup • Committee (and subcommittee) chairs • After referral to subcommittee • Into the Garbage can • Hearings • Markup • Vote • Same process at full committee level • Before it goes to the floor: Rules committee • Powers of the Speaker of the House
How a bill becomes a law • Same process in the other chamber • Senate.gov • Referral to the committee(s) with jurisdiction • Committee (and subcommittee) assignment • Committee (and subcommittee) chair • After referral to subcommittee • Into the Garbage can, hearings, Markup, Vote • Same process at full committee level • Floor procedure • Unlimited debate, filibuster, cloture • Powers of the Majority leader
How a bill becomes a law • Bill that passes both houses goes to Conference Committee • Re-passage of identical bill in both houses • President’s Desk for veto or signature • 2/3 vote in both houses to override
Questions • Which is easier: passing a bill or stopping a bill from passing? • What are the majority party’s advantages in the House? The Senate? • What are the minority party’s advantages in the House? The Senate? • Who controls the agenda? • Who controls the content of legislation? • What is the president’s role in the legislative process? What is his bargaining position?
Terminology • Terminology: • Medicare • Medicaid/Medical • HMO/PPO • Fee for service • Premium • Employer Mandate • Individual Mandate • Deductible • Catastrophic coverage • Others??
Topics for discussion • What are your personal experiences with the health care system? What do you think are the “problems” with the health care system? • What are the cost issues associated with health care reform?
Health care costs rise quickly • Expenditures on health care in the economy: • 1980:$253 billion • 1990: $714 billion • 2007: $2.2 trillion, 16% of GDP • 46% of health care spending is public spending
Health care expenditures(From the Kaiser Family Foundation background brief on health care costs, 9/13/09)