Congress agreed Thursday to amend the nation's new health-care law, concluding a long, contentious quest to pass major changes, and lawmakers prepared to head home for a two-week recess to hear voters' reactions.

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WASHINGTON — Congress agreed Thursday to amend the nation’s new health-care law, concluding a long, contentious quest to pass major changes, and lawmakers prepared to head home for a two-week recess to hear voters’ reactions.

Members of both parties are leaving Washington on a rancorous note. They seethed over the political response to threats of violence against a number of House Democrats, and senators belittled one another during amendment votes that lasted nearly 21 consecutive hours.

The last legislative hurdle to clear before recess was a reconciliation bill that contained a number of “fixes” to the health-care law and an overhaul of the student-loan program and expansion of Pell Grants. The measure was designed to proceed through Congress along a fast track, but it bogged down nevertheless.

Many of the changes were intended to address the concerns of House Democrats and to bridge differences between the original House and Senate bills and to incorporate additional provisions sought by President Obama.

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Senate Republicans forced 41 votes to strip or alter provisions — although Democrats won every one — and identified 20 words that violated procedural rules, requiring the bill to return to the House to be approved a second time.

Both parties believe they are emerging from the health-care debate in the stronger political position, going into midterm elections.

Democrats are convinced Americans will warm to the legislation once they have a chance to digest it. Republicans are just as certain voters will dislike the measure even more as they absorb its scope and cost. They contend Democrats defied the public’s wishes by passing legislation that expands the government’s role in health care, cuts Medicare and raises taxes on wealthy Americans.

“The important thing now … is to replace those who voted for the health-care bill and to repeal it when we get some new members here,” Sen. Jim DeMint, R-S.C., told Fox News’ Sean Hannity.

Obama was in Iowa City, where he opened an aggressive public-relations blitz to sell the package.

Speaking to a crowd of about 3,000, he dared Republicans to follow through on their pledges to repeal the law, which would require them to win back big enough majorities in November to override his veto.

“My attitude is, go for it!” Obama said. “If these congressmen in Washington want to come here to Iowa and tell small-business owners that they plan to take away their tax credits and essentially raise their taxes, be my guest.”

In the end, the reconciliation bill passed the Senate 56-43, and the House approved it again, this time on a 220-207 vote. It goes to Obama for his signature.

Three Senate Democrats — Blanche Lincoln and Mark Pryor of Arkansas and Ben Nelson of Nebraska — voted against the bill, which needed only a simple majority because Democrats used the budget-reconciliation process to avoid a filibuster. In the House, 32 Democrats voted against the bill.

The Washington state delegation voted along party lines, although Republican Rep. Dave Reichert missed the vote after being hospitalized because of bleeding on the brain. He is expected to make a full recovery.

“We have worked and waited for this moment for a century,” said Senate Majority Leader Harry Reid, D-Nev. “This, of course, was a health bill. But it was also a jobs bill. It was also an economic-recovery bill. It was a deficit-reduction bill. It was an anti-discrimination bill. It was, truly, a bill of rights. And now it is the law of the land.”

“The only thing bipartisan about today’s vote is the opposition to this bill,” retorted Tennessee Sen. Lamar Alexander, a member of the Senate Republican leadership. “It is a historic mistake.”

With health care off the agenda, Republicans are turning to other legislative targets. The Senate on Thursday considered a temporary extension of unemployment benefits and quickly was ensnared in another procedural standoff.

Under the “fixes” bill adopted Thursday, uninsured people would receive enhanced subsidies to buy coverage, federal funding of Medicaid would increase, and seniors would see the “doughnut hole” coverage gap disappear in Medicare prescription-drug policies.

The amendments also speed up enactment of new insurance restrictions that will particularly benefit people with chronic-medical conditions. And in six months, uninsured adults under 26 may be added to their parents’ health plans.

Information from The New York Times, the Tribune Washington bureau and The Associated Press is included in this report.

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