The Senate cleared a set of key procedural hurdles on President Obama's health-care legislation early Tuesday with more party-line votes, continuing the effort to pass the $871 billion bill before Christmas.

All 60 members of the Democratic caucus supported votes that set up a third and final 60-vote hurdle for Wednesday, while all 39 Republicans in the chamber voted to block the action.

With tempers continuing to simmer on the Senate floor, Majority Leader Harry M. Reid (D-Nev.) pleaded for cooler heads to prevail in the holiday season. "I would hope that everyone would go back to their gentlemanly ways," Reid said, invoking the plea of Los Angeles resident Rodney King after riots erupted in 1992 following the trial in his police beating case.

"Let's just all try to get along."

Minority Leader Mitch McConnell (R-Ky.) gave his first public indication that Republicans, faced with certain defeat in their effort to block the legislation, would consider yielding some of the debate time that will follow the Wednesday afternoon vote.

By rule, Republicans could force another 30 hours of debate before final passage of the historic legislation, which probably would mean no roll-call vote until after 9 p.m. Christmas Eve. But McConnell acknowledged that he and Reid were "working on an agreement that would give certainty" to when that final vote would occur, a signal that senators might not have to wait until late Thursday night to finish up the first Dec. 24 session in 46 years.

It was the second time in five days that the Senate -- now in its 23rd straight day of legislative action, all of which has included debate on health care -- has convened in the wee morning hours to hold votes. In addition to the votes Tuesday, which began at 7:30, and a 6:45 a.m. vote Saturday, there were two votes that began shortly after 1 a.m. -- on a defense bill Friday, and on the health-care package Monday.

On Tuesday, Sen. James Inhofe (R-Okla.) was the only senator absent. His opposition to the legislation is widely known and his vote would not have affected the outcome.

All three votes Tuesday were strictly party line, 60-39. One of the votes formally inserted Reid's last-minute amendments, which included the final compromises needed to secure the unanimous support of his caucus, into the nearly 2,500-page legislation. Another vote cleared the filibuster hurdle on the new, complete package. A final filibuster vote, known as a cloture motion, needs to be cleared Wednesday afternoon before the Senate can move to final consideration of the bill.

Lacking the votes to block the bill, Republicans continued to heap scorn on the many concessions made to wavering Democrats in the quest to advance the package.

Sen. David Vitter (R-La.) took to the floor to lambaste Sen. Mary Landrieu (D-La.) for securing better payments from the federal government for their state's Medicaid program, which could add up to $300 million. Some have called that side deal the "Louisiana Purchase," but Vitter's speech was titled the "Louisiana Sellout," a particularly sharp critique of his home-state colleague.

On Monday, Republican Party Chairman Michael S. Steele accused Democrats of "thumbing their nose and flipping the bird to the American people." Conceding that the Senate bill is virtually unstoppable, Steele said in a conference call with reporters: "I intend to have my foot on the throats of the Democrats on this issue and hold them accountable." Democrats seeking reelection in 2010, he warned, "can look for their pink slips."

Reid responded by telling reporters he was "disappointed" by Steele's remarks, calling them "crass and such a terrible example for the youth of this country."

But Reid defended the long list of revisions to the bill, which were needed to secure the backing of moderate Democrats such as Sen. Ben Nelson (Neb.). Those changes contained additional Medicaid funding for specific states including Nebraska, exemptions for certain insurance companies and tighter restrictions on abortion coverage. "There are 100 senators here, and I don't know that there's a senator that doesn't have something in this bill that isn't important to them," Reid told reporters. "If they don't have something in it important to them, then it doesn't speak well of them."

The majority leader compared the legislation to a defense bill, typically thick with earmarks, many benefiting specific companies. "That's what legislation's all about," said Reid. "It's the art of the compromise."

Senate Democratic leaders received good news Monday when the American Medical Association endorsed the legislation. The group generally has supported the Democrats' reform effort but had raised concerns throughout the year-long drafting process.

AMA President-elect Cecil B. Wilson stood alongside Democratic leaders and praised the Senate for bringing "us close to the finish line on health-system reform."

Wilson applauded Reid's decision to drop a tax on elective cosmetic surgery, replaced in the final bill with a levy on tanning-salon services. The Senate bill also would increase payments to primary-care physicians and general surgeons in rural and underserved areas, without cutting payments to other doctors, Wilson noted. A proposed physician enrollment fee for Medicare was dropped.

But Wilson signaled other concerns that he said the AMA would address if the bill advances to a House-Senate conference in January. Those issues include the scope of powers given to a proposed Medicare payment board, proposed as a way to rein in costs in the insurance program for seniors. Wilson also questioned quality-improvement and Medicare data-release initiatives that physicians have resisted.

And Wilson said the AMA is counting on Democratic Senate leaders to follow through with their pledge to change the Medicare physician payment system, which makes doctors lobby each year to prevent deep cuts in reimbursements. "We will continue to work closely with them to get that solution," he said.

Staff writer Perry Bacon Jr. contributed to this report.

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