June 6, 2023

The revision process began shortly after 11:30 p.m. ET and was dubbed the “vote puller” on Capitol Hill. A final vote on the bill will take place after voting on the amendments closes, and it’s unclear when exactly.

The package, the product of tough negotiations, will give Democrats a chance to achieve key policy goals ahead of the upcoming midterm elections. Senate Democrats are using a special process to pass the bill without a Republican vote.

Once the legislation has passed the Senate, it needs to be approved by the House of Representatives before President Joe Biden can sign it into law. The House is preparing to return to discuss the legislation this Friday, according to the office of House Majority Leader Steney Hoyer.

Senate Democrats only need a simple majority to finally pass the bill because they are using a process called reconciliation, which allows them to avoid Republican obstruction and the corresponding 60-vote threshold.

However, in order for the bill to pass the reconciliation process, the package must adhere to a strict set of budgetary rules. Republicans are using “vote-a-rama” to put Democrats on the spot and vote hard politically.

As expected, the key insulin provision was removed from the bill after Republicans raised procedural issues, leading to a vote to remove it.

The final vote was 57-43. A threshold of 60 votes is needed to keep the provision in place.

The bill originally contained provisions that capped the price of insulin in the private insurance market and Medicare at $35 a month. But Senate members ruled that insulin caps in the private insurance market did not meet the settlement rules Democrats used to push their legislation through the House.

Democrats kept both provisions in the bill anyway, but Republicans raised a procedural issue to force a vote to remove them only from private markets. Medicare’s $35 insulin cap is still in effect.

CNN’s Manu Raju and Kristin Wilson contributed to this report.

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