This was ostensibly a vote on a motion to waive the Senate's budget rules with respect to an amendment by Sen. Bob Bennett prohibiting the District of Columbia from issuing marriage licenses to same-sex couples until the city holds a referendum on whether or not legalize same-sex marriage. The measure Bennett sought to amend was a “companion bill” making a number of changes to health care reform legislation already signed into law by President Obama. The underlying context was that Republicans were trying to attach amendments to the companion bill in order to send it back the House, where it had passed by a narrow margin. CNN reported that Republicans had chosen to offer a slew of amendments in order to “undermine the measure,” while the Associated Press characterized the amendments as “a final drive to thwart President Barack Obama's health care remake.”

Bennett contended his amendment “would allow the people of the District of Columbia to exercise the same right that has been exercised by 31 States with respect to the issue of whether there would be gay marriage in their jurisdiction. This bill does not take any position with respect to gay marriage, simply allows the District to hold a referendum.”

Sen. Max Baucus (D-MT) argued the amendment was unrelated to the federal budget, and therefore violated the Senate’s budget rules. Under these rules, amendments cannot be adopted to legislation brought up under the budget reconciliation process if those amendments are not strictly relevant to budgetary matters.  Baucus said: “…No matter where you are on the issue of marriage, no matter where you are on the issue of DC home rule, we ought to be able to agree that neither issue has anything to do with this bill…” Bennett made a motion to waive those budget rules. Motions to waive the budget rules require 60 votes for passage.

After the House and Senate both passed their respective health care reform bills, the two chambers had intended to reconcile those two bills into a final package. After the House and Senate passed that final package, it would have been sent to President Obama, who would have signed it into law. Sen. Scott Brown (R-MA), however, won a special election to replace the late Sen. Ted Kennedy (D-MA) before the final health care bill could be brought up for a vote. Brown's victory gave Republicans 41 votes in the Senate, leaving Democrats with 59 members – one vote short of the 60 votes they needed to defeat a unanimous Republican filibuster against the final health care bill. 

In order to pass comprehensive health care legislation without a 60-vote majority in the Senate, Democratic leaders devised a plan in which the House would pass the Senate health care bill (H.R. 3590), thereby enabling the president to sign it into law. The House would then pass a separate companion bill (H.R. 4872) to make changes to the Senate health measure under a process known as "budget reconciliation." Bills considered under budget reconciliation cannot be filibustered under Senate rules. This process allowed the House to make changes to Senate-passed health care legislation without sending the entire health bill back to the Senate, where it could have been filibustered indefinitely.   The companion bill incorporated changes to the Senate health care legislation desired by House Democrats. The House passed the companion measure, and sent it to the Senate, where Democratic leaders hoped to defeat all amendments -- thereby avoiding a second vote in the House on a substantively changed bill; a vote that Democrats might have lost given the already tight margin when it was voted on the previous week.

The Senate rejected the motion to waive its budget rules by a vote of 36-59. 36 Republicans voted “yea.” All 57 Democrats present and 2 Republicans voted “nay.” As a result, the Senate effectively rejected an amendment Democratic leaders fearedcould have torpedoed the entire companion health care bill and would have prohibited the District of Columbia from issuing marriage licenses to same-sex couples until the city holds a referendum on whether or not legalize same-sex marriage.