After Senate Republicans succeeded in forcing a new House vote on the "fix-it" health care bill, congressional Democrats are now scrambling to finish work on the legislation before leaving town this weekend for Easter recess.
The Senate passed the follow-up health care bill Thursday afternoon, 56-43. Three Democrats, Sens. Ben Nelson of Nebraska and Blanche Lincoln and Mark Pryor of Arkansas, joined Republicans in voting against the bill.
But the bill still has to return to the House for final congressional approval, after the Senate parliamentarian determined early Thursday morning that two Republican challenges succeeded in stripping out language in the package.
Altering the bill in any way means it has to return to the House side, which first approved the package of changes Sunday, since both chambers must pass identical versions.
House leaders predict their chamber will complete the bill by day's end.
The package of changes, which is being considered under "reconciliation" rules allowing the Senate to approve it with just 51 votes, is the final piece of the legislative puzzle to the health care reform package signed into law Tuesday. Health care reform is officially enacted, but House Democrats wanted the package of fixes to change the way it's financed and address other concerns.
The glitches have to do with Pell grants for low-income students.
A senior Senate Republican leadership aide told Fox News that Democrats had tried to improve the cost of the bill while simultaneously piling on Pell grants "without mandating the spending." The aide said Democrats claimed the grants would increase, but were relying on a "future Congress" to find the funding.
"They can't do that," the aide said. "This was one of 100 gimmicks used to keep the score down."
Republicans have been hunting for such violations in hopes of bringing down the legislation. Democrats had also been consulting with the parliamentarian, Alan Frumin, and hoped they had written a measure that would not be vulnerable to such problems.
The two provisions were formally removed from the bill on Thursday. Both chambers are hoping to begin a spring recess by this weekend.
Besides reshaping parts of the landmark health overhaul, the legislation transforms the federal student loan program -- in which private banks distribute the money -- into one in which the government issues the loans directly. That produces some federal savings, which the bill uses in part to increase Pell grants to needy students.
The legislation would change the new health care law by making drug benefits for Medicare recipients more generous by gradually closing a gap in coverage, increasing tax subsidies to help low-income people afford health care, and boosting federal Medicaid payments to states.
It kills part of the new statute uniquely giving Nebraska extra Medicaid funds -- designed to lure support from Nelson -- that had become a glaring embarrassment to Democrats. It also eases a new tax on expensive health coverage bitterly opposed by unions and many House Democrats, while delaying and increasing a new levy on drug makers.
The Associated Press contributed to this report.