Democrats eager to get the contentious issue behind them had hoped that the Senate's 56-43 vote Thursday would finish lawmakers' work on the measure.
But Republicans managed to kill a minor provision on grants for low-income students that violated Congress' budget rules. So now, the House has to approve an identical bill before President Barack Obama can sign it.
House leaders predict their chamber will complete the bill by day's end. The measure boosts health care subsidies for low-income people and reduces new taxes on high-cost health insurance policies.
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