On January 6, 2016, the House voted on H.R. 3762, Restoring Americans' Healthcare Freedom Reconciliation Act. The House approved the bill 240 to 181.

Previously in early December, the Senate approved the reconciliation bill 52 to 47. Because the Senate made changes to the House-passed reconciliation bill, it had to go back to the House for approval before it could be sent to President Obama's desk.

Republican leaders used the budget reconciliation process in an effort to dismantle key provisions of the Affordable Care Act (ACA). The Administration released a Statement of Administration Policy (SAP) making clear that the President will veto the reconciliation bill. While a Presidential veto is nearly certain, the passage of the reconciliation bill allows opponents of the ACA to send HR 3762 repealing major elements of the ACA to the President's desk for the first time.

Previous Senate actions on the reconciliation bill

In December, the Senate approved a motion that initiated 20 hours of debate on the reconciliation measure and senators voted on amendments to the bill. The reconciliation bill only needed a simple majority, 51 votes, to pass the Senate and it could not be filibustered.

According to the Congressional Budget Office and the Joint Committee on Taxation, the reconciliation package would decrease the federal deficit by $295.6 billion over the ten-year budget window 2016 to 2025.

Senate Republicans modified the previously House-passed reconciliation legislation with a number of amendments. The House-passed bill repealed the individual mandate, employer mandate, "Cadillac" tax, and medical device tax, prohibited funding to Planned Parenthood for one year, and eliminated the Public Health and Prevention fund. The substitute amendment taken up by the Senate changed the individual and employer mandate penalties to $0, rather than outright repealing them, in order to comply with the rulings of the Senate Parliamentarian.

During the vote-a-rama, Leader McConnell introduced a new "wrap-around" substitute amendment that added in a number of new provisions, including provisions to end the Exchange premium tax credit and cost-sharing subsidies, remove the Secretary's authority to run the health insurance marketplaces by 2018, stop the collection of user fees for the three risk mitigation programs, and scale back the Medicaid expansion. The substitute also repealed additional fees and taxes that were included in the Affordable Care Act, including the pharmaceutical manufacturer fee, the health insurer fee and the so-called "tanning tax".

The House did not make any additional changes to the Senate-passed bill.