...so-called “Cadillac plans.” SMACNA’s President John Lindemulder supports the measure. The Senate “made a common-sense decision not to tax the value of construction industry plans at the same level it would for other industries,” he says. Construction workers deserve health care “commensurate” with their work, and employers should not be penalized for high-value plans, he adds.

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 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 those 60 votes.”

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

Although the Senate’s tally went as forecast, there were items 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.

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 Massachusetts Democrat who died last August, had tried through his long Senate career to achieve an overhaul of the health-care system.

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.”