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Arlen Specter switched to the Democratic party in Aprilgiving them 60 seats, enough to end a filibuster. Negotiations were undertaken attempting to satisfy moderate Democrats and to bring Republican senators aboard; particular attention was given to Republicans Bennett, Enzi, Grassley and Snowe. After the Finance Committee vote on October 15, negotiations turned to moderate Democrats.

Senate Majority Leader Harry Reid focused on satisfying centrists. Lieberman's demand that the bill not include a public option [] [] was met, [] although unlv health family medicine clinic won various concessions, including medicinne state-based public familh such as Vermont's failed Green Mountain Care.

The White House and Reid addressed Nelson's concerns [] during a hour negotiation with two unlc a compromise on abortionmodifying the language of the bill "to give please click for source the right to prohibit unlv health family medicine clinic of abortion within their own insurance exchanges", which would require consumers to pay for the procedure medivine of pocket if the state so decided; and an amendment to offer a higher rate of Medicaid reimbursement for Nebraska.

On December 23, the Senate voted 60-39 to end debate on the bill: a cloture vote to end the filibuster.

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