A flurry of activity awaits the new president with an eager Congress getting its start a few weeks earlier. Sworn in on Jan. 3, the House and Senate began making good on their most ambitious goals, often repeated but never accomplished, to repeal the Affordable Care Act, with a goal to get legislation to President Trump’s desk by Feb. 20.


In return, Democratic supporters of the law, to include the outgoing president, have responded to these moving targets in several ways, such as daring the Republican majority to take away health care for 20 million users and newly minted Senate Minority Leader Charles Schumer suggesting Republicans are on the cusp of “making America sick again.”


How the law is written, what remains and what’s eliminated are some of the biggest unknowns, the devil in the details as it’s said. Known as a transition period or transition rules, this is the time between when the law is repealed and the date when the law actually ends. Remember, the president may sign into law legislation that effectively repeals the Affordable Care Act on Feb. 20, 2017, but all it takes is legislative language in the new law that sets the date of repeal for another time, thus setting up the time in between as a transition. Most expect it to be no less than two years to enable lawmakers to craft a replacement law, with it, too, needing its own period of transition.


Sunset provisions, as they’re known, are a useful tool for a number of reasons. First, if a date-certain is written into law that forces an expiration of the law, then Congress is required to act. Second, a number of policymakers hold a dim view philosophically of making anything permanent. By adding a sunset to a particular provision, usually one that is a bit controversial, enough “yes” votes likely are to be found in the House or Senate.


Getting back to what’s in it and what’s not, there likely is to be as much written about this law’s fate as the 2016 election coverage. The new president already has spoken in favor of retaining some of the law’s existing provisions, such as allowing children up to the age of 26 to remain on the parent’s plan and the prohibition to deny coverage to those with preexisting conditions.


Now on to the how. In the House, a simple majority of 218 is required to pass legislation. It’s in the Senate where legislation has been known to languish and die, as 60 votes in favor are needed in order to advance — with one exception.


On its first day of business, by a vote of 51-48, the Senate voted to move ahead in debating a fiscal 2017 budget resolution that would include reconciliation instructions repealing the 2010 health-care law. The motion to proceed to the resolution required only a simple majority vote. Known in Washington as reconciliation, a fiscal 2017 budget resolution unveiled on the first day of the 115th Congress includes instructions to two House and two Senate committees to craft legislation reducing the deficit by $1 trillion over the next 10 years. To do so, those committees will draft bills repealing portions of the health-care law. Senate debate is not subject to cloture, meaning 60 votes are not required to end debate. Republicans, with their 52-seat majority, will be able to advance the repeal without needing any Democratic defections.


Senate Democrats have signaled they’ll use the full amount of time afforded to them to debate this issue, which will be 50 hours of debate evenly divided. Over the next year, an air war of messaging can be expected, with the potential to crowd out some issues and shield others.

To be sure, health care has once again landed on the front burner in Washington. Every stakeholder has the responsibility and ability to use their voice to help shape the outcomes of these respective laws.