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The Senate passed a slightly altered health care “fixes” bill Thursday, sending it to the House of Representatives for final approval.

House Speaker Nancy Pelosi said Democrats have the votes to pass the measure later Thursday and send it to President Obama to be signed into law. She said lawmakers want to “finish our work up today” before going on a two-week recess.

The so-called fixes bill, approved by a 56-43 vote, makes changes in the overall health care reform measure signed into law Tuesday by Obama.

Senate Republicans forced two minor provisions involving student loan funding to be stripped from the bill, but the changes would not affect the law Obama enacted Tuesday.

A Senate Republican Budget Committee memo said the violations raised by GOP senators involved Pell grant spending that won’t immediately affect the federal budget, and therefore was ineligible for inclusion in the measure. That’s because the measure was being passed under reconciliation rules, which apply only to budget-related measures.

On Sunday, the House passed both the overall health care bill and the accompanying fixes bill as part of a complicated legislative process necessary to overcome unanimous Republican opposition.

Republicans used every parliamentary tool available to try to undermine both the overall health care bill and the fixes measure. They forced the Senate to begin deliberations on a series of proposed amendments starting Wednesday night. The Senate did not adjourn until 2:45 a.m. Thursday.

The Senate reconvened at 9:45 a.m. to consider additional GOP proposals which, among other things, were designed to force Democrats to cast unpopular votes in the run-up to November’s midterm elections.

The Democrats’ fixes bill was necessary to get a reluctant House to pass the Senate’s health care reform measure unchanged. If there had been any changes to that initial bill, it would have had to go back to the Senate for another vote, which almost certainly would have failed. Since a special election earlier this year in which Democrats lost the Senate seat formerly held by Sen. Ted Kennedy, the party has not had enough votes to overcome a Republican filibuster.

That situation prompted the two-bill strategy Democrats are using. After passing the Senate bill without changes, House Democrats passed the fixes bill Sunday to alter provisions they did not like. Because the bill was being handled under the reconciliation rules in the Senate, only 51 votes were needed for passage.

The compromise package would add more than $60 billion to the overall plan’s cost partly by expanding insurance subsidies for middle- and lower-income families. It also would expand Medicare’s prescription drug benefit while scaling back the bill’s taxes on expensive insurance plans.

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Article courtesy cnn.com