Sweeping legislation seemed to be on the brink of passage in January, after both houses approved bills and lawmakers began working out a final compromise in talks at the White House. But those efforts were sidetracked when Republicans won a special election in Massachusetts -- and with it, the ability to block a vote on a final bill in the Senate.
Now, nearly two months later, lawmakers have embarked on a two-step approach that requires the House to approve the measure passed by the Senate, despite misgivings on key provisions. That would be followed by both houses quickly passing a second bill that makes numerous changes to the first. In the Senate, that second bill would come to a vote under rules that deny Republicans the ability to filibuster.
The details of the second, fix-it measure were closely guarded -- and subject to last-minute changes. In general, officials have said they would provide more money for lower-income families unable to afford health care and states that already provide above average coverage for the poor under Medicaid, as well as improved prescription drug coverage under Medicare.