If the final version of the health care reform bill must resemble more closely what was passed by the Senate, as lawmakers on Capitol Hill say, the House's public option is probably out but the fate of the Senate's special provision targeting construction remains uncertain.

Industry Now Has Bigger Stake In Final Health-Care Compromise
Some contractor groups whose workers tend to be unionized are supporting the Senate's special construction industry amendment.

After the Senate's approval of a measure that aims to make broad changes in the U.S. health-care system, the focus will turn to negotiations to reconcile the newly passed Senate bill with the version the House cleared in November. That compromise then would require passage by the full House and Senate.

The Senate approved the $871-billion measure early on Christmas Eve, on a 60-39 party-line vote.

Afterwards, Senators said that the final bill that emerges from talks with the House would have to remain close to the version that cleared the Senate. The Senators noted that their 60-vote majority for the bill represents a carefully crafted but fragile compromise.

When House and Senate negotiators begin in coming weeks to hammer out a final compromise version, construction will be paying close attention to one particular provision that is in the Senate's bill, but not the House's.

The provision, sponsored by Sen. Jeff Merkley (D-Ore.), would require construction firms with five or more employees to provide health-insurance coverage for their workers, or pay a penalty. For non-construction companies, the Senate bill sets the health coverage threshold at firms with 50 or more workers.

Construction groups are divided over Merkley's provision. It has strong support from some organizations, including the National Electrical Contractors Association and Sheet Metal and Air Conditioning National Contractors Association, whose companies tend to be unionized. But the language drew fire from other groups, including the Associated Builders and Contractors and Associated General Contractors.

Looking ahead, Sen. Ben Nelson (D-Neb.), a key, late-deciding vote for the bill, said after the final tally that the eventual House-Senate compromise version will have to look more like the Senate bill than the House's. He said that the Senate's 60-vote majority "has been put together very carefully...but the agreement is quite tentative...."

Sen. Joseph Lieberman (I-Conn.), who also was won over to support the measure, said, "This is a very finely, delicately, precariously balanced 60 in the Senate in favor of health-care reform....Any significant changes, I think, will threaten that 60 votes."

Also standing outside the Senate chamber after the health-care bill was approved was Rep. John Dingell (D-Mich.), a veteran of earlier health-care legislative debates. "The House members are divided rather like the Senate members are," he said. House liberals are concerned that the Senate bill lacks the House measure's government-supported "public option" for insurance--"and that's a serious problem." But Dingell added that "the Republicans are concerned in a different way over different matters."

Dingell predicted "a lot of surprises, some of them unpleasant," but in the end, he said, "I think that the House will come together behind this bill. And I'm fearful that it will be as you saw in the Senate a largely partisan divide."

Asked whether the final bill will have to resemble the Senate version to win congressional passage, Dingell replied, "In a poker game, I never show my hole card."

He added. "Everybody's going to have to give. That's part of the great constitutional mechanism that we are a part of. Everybody has to give, a little."

Although the Senate's tally went as forecasted, there were notes that indicated this was an unusually important vote. Vice-President Joe Biden presided over the proceedings, a relatively rare occurrence, and senators rose at their seats to cast their votes--a practice reserved for noteworthy legislation.

The Senate's longest-serving member, 92-year-old Robert Byrd (D-W.Va.), answered "present" when the clerk called his name, and then said, "This is for my friend, Ted Kennedy," before voting "aye." Kennedy, the late Massachusetts Democrat, had tried through his long Senate career to achieve an overhaul of the health-care system.

Majority Leader Harry Reid (D-Nev.), who painstakingly modified the bill to cement the votes of lawmakers like Nelson and Lieberman, drew good-natured laughter from both sides of the aisle when he at first seemed to vote no on the measure. But then Reid quickly corrected himself, saying, "Yes. Aye."

Republicans plan to keep battling against the health-care bill, said Senate Minority Leader Mitch McConnell (R-Ky.) Speaking on the floor shortly before the final vote, McConnell blasted the measure as a "monstrosity" and added, "This fight is long from over."