Overview of the Open, Transparent, Lengthy Process of Enacting the Affordable Care Act



  • The House held 79 bipartisan hearings and markups on health insurance reform in 2009 and 2010.
  • In these bipartisan hearings and markups, House Members heard from 181 witnesses from both sides of the aisle, considered 239 amendments (both Democratic and Republican), and accepted 121 amendments.
  • In mark-up, Energy & Commerce Committee adopted 24 GOP amendments.  In mark-up, Education & Workforce Committee adopted 6 GOP amendments.
  • The original House bill was posted online for 30 days before the first Committee began their mark up and more than 100 days before the tri-committees formally introduced their merged bill in the House.
  • House Democrats posted their first House bill online for the promised 72-hour review.
  • The Senate bill voted on in the House was online for three months, and the reconciliation bill was online for 72 hours of review before the final vote.
  • House Democrats heard and answered questions from constituents at more than 3,000 health care town halls and public events, and tens of thousands of e-mails, calls, and letters were logged in Congressional offices to register public comment.


  • The Senate Finance Committee held more than 53 hearings on health insurance reform. They spent 8 days marking up the legislation – the longest markup in 22 years – during which they considered 135 amendments.
  • The Senate HELP Committee held more than 47 bipartisan hearings, roundtables, and walkthroughs on health insurance reform. They considered 300 amendments during a 13 day markup.
  • The Senate Finance Committee posted their legislation online for 6 days before the markup.
  • The Senate HELP Committee posted their legislation online for 6 days before the markup.
  • The Senate spent 25 consecutive days in session on health reform, the second longest consecutive session in history.
  • In total, the Senate spent more than 160 hours considering the health reform legislation.
  • The final Senate bill included 147 Republican amendments.