Sen. Ben Nelson, D-Neb., provided the vital 60th vote that ended Republican attempts to filibuster the bill and bring it to a final vote after a weekend of strong pressure from Senate leader Harry Reid.
In return Nelson secured increased federal funds to cover Nebraska's expanding Medicaid population.
He also got compromise language on abortion funding designed to keep taxpayer funds separate from private premiums, which can be used to fund abortions. But the compromise appears to satisfy neither supporters nor opponents of abortion rights and Nelson, an abortion opponent, is facing a backlash from anti-abortion groups.
The bill covers more than 30 million currently uninsured people and will provide subsidies for lower income individuals. It prevents insurers from rejecting those with pre-existing medical conditions and establishes new health insurance marketplaces.
If the bill passes it still has to be reconciled in conference with the House bill that provides for a public health insurance option. That option was dropped from the Senate bill to secure its passage and is likely to prove a rallying point for liberals dissatisfied with what the Senate has produced.