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Republicans argued that the partisan health debate threatened to permanently divide the parties in the Senate.

“This bill in process is a game changer in the way the minority will operate, said Lindsey Graham, South Carolina Republican.

He all but ruled out further compromises on the immigration debate, but said he will still work on bipartisan climate-change legislation.

Democratic Sens. Ben Nelson of Nebraska, and Blanche Lincoln and Mark Pryor of Arkansas joined all Republicans in opposition. Ms. Lincoln, who is in a tough re-election fight, had said she planned to vote against the package because it was passed through reconciliation. Mr. Pryor said the repair bill ended up hurting Arkansas by reducing how much the federal government paid for Medicaid.