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How Laws Are Made
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The United States government makes laws in three ways: Legislation in Congress, Executive Branch rule making, and Federal Court decisions. Individuals can participate by voting and communicating with their legislators on the local, state and federal levels.

In Congress, a bill is introduced in one or both chambers (House and Senate). You will see H.R - House of Representatives, or S- Senate in front of a bill’s number - these letters refer to either the House or Senate version of the bill.

After a bill is introduced, it is referred to one or more committees and/or their subcommittees. Most bills never make it out of committee, but if they do, there is a series of events that often take place – first a hearing on the bill/issue in the committee of jurisdiction, followed by a markup which means changes or amendments are made in an open forum. If the bill is reported favorably, the bill comes out of committee to be considered by the full House or Senate.

If passed, it is sent to the other body. Often the other chamber may already have introduced a similar bill. In this case, if both Chambers pass bills that differ, they are sent to a conference committee to be negotiated so that the language is identical. This is where deals are made, and differences are ironed out.

Agreements on language of the bill by both the House and Senate must be made for a final vote. If the same bill is passed by both Houses, it is sent to the President for signature.

The President may veto the bill, but Congress may override the veto by a 2/3 vote of each Chamber of Congress. Once the President signs the bill, it becomes law.

As citizens and nurses, you can impact the process from beginning to end. Many laws start as ideas by individuals about problems that they are experiencing in their hometown or submitted by various special interest groups such as NOVA, AARP, Disabled American Veterans, and others.

The more constituents who contact their representatives with their support for, or opposition to a bill, the more chance you have in influencing and getting the bill moving through the process. Particularly if the bill affects many veterans, families and colleagues. Members of Congress are always interested in what is happening locally – the statement “All Politics is Local,” remains true an effective in building your case for legislation.