In order for a bill's provisions from the House healthcare bill (Senate bill plus reconciliation bill), there is a process or timeline that it needs to go through. The necessary actions and considerations that need to be looked at are: Additional requirements for section 501(c)(3) hospitals Study and report of effect on veterans' health care Provide income exclusion for specified Indian tribe health benefits Codify economic substance doctrine and impose penalties for underpayments Provision specifying that subsidies or tax credits received through health care reform will not affect individual's qualifications for other federal programs Tax Exemption for Certain Member-Run Health Insurance Issuers Tax Exemption for Entities Established Pursuant to Transitional Reinsurance Program for Individual Market in Each State Rules pertaining to how the IRS is involved in income-verification and individual status for the purposes of participation in the exchanges and subsidies received. All of these need to be looked at before they are signed into law. In order to finance $940 billion in new health care spending over the next ten years, the health care bill that the House of Representatives passed on Sunday evening contains many spending cuts to Medicare, along with many tax increases that are set to go into effect over the next decade. Courtesy of the Joint Committee on Taxation's scoring of each of the provisions in the bill and the CBO, this Tax Foundation Fiscal Fact contains a timeline of when each of the tax provisions in the bill is set to go into effect. This is referred to as the Fiscal Fact #218.