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The U.S. Senate is poised tomorrowto take an early morning vote that will lead toward passage ofthe most sweeping overhaul of the nations health-care system inmore than four decades.

Senate Majority Leader Harry Reid plans to win finalpassage by Dec. 24 now that he secured the vote of his partyslast holdout, Nebraska Senator Ben Nelson. The 10-year, $871billion bill is designed to cover 31 million uninsuredAmericans, curb costs and place new restrictions on insurers.

The vote to cut off debate is scheduled for 1 a.m. in aU.S. Capitol blanketed by snow and filled with weary senatorsand staff. Democrats, finally united in favor of the bill, areusing the clock to overcome delaying tactics by Republicansuniversally opposed to the effort.

Nelson had held out the possibility Reid wouldnt meet hisdeadline of Christmas passage as he objected to parts of thebill, giving critics hope for more time to marshal opposition.He finally struck a deal that satisfied his demand to keep U.S.subsidies from being used for abortion and won an agreement formore aid to help Nebraska provide coverage for the uninsured.

The American people will have the vote they deserve ongenuine reform, President Barack Obama, who has made the issuehis top legislative priority, told reporters yesterday. We areon the cusp of making health-care reform a reality.

It was a pretty powerful moment, said Reid, a NevadaDemocrat. Thats what this place is built on, handshakes.

The agreement came late on Dec. 18 over a handshake.

The Republican leaders in both the House and Senate, OhioRepresentative John Boehner and Kentucky Senator MitchMcConnell, called the bill a monstrosity.

Reid needed Nelsons support because passage will requireall 60 votes controlled by Democrats to cut off stalling tacticsfrom Republicans, who say the measure would raise taxes, hurtinsurers and widen the federal budget deficit.

Senator Olympia Snowe, a Maine Republican targeted byDemocrats as a potential supporter of the health-care proposal,said on CBSs Face The Nation today that Democrats arerushing the vote without allowing enough evaluation.

A bill like this shouldnt be done on a narrowly partisanbasis, McConnell said at a Capitol Hill press conferencetoday. We shouldnt try to jam through legislation thisrapidly.

White House senior adviser David Axelrod defended themeasure on three Sunday talk shows, saying its not perfect,and over time, it may improve on NBCs Meet the Pressprogram. This is major reform.

There is no magic deadline, Snowe said. This beatthe clock is really overruling legislative sanity.

Like the $1 trillion measure passed Nov. 7 by the House,the Senate plan would require Americans to get health coverageor pay a penalty. It would expand the Medicaid health programfor the poor, set up online insurance-purchasing exchanges andprovide subsidies for those who need help buying policies. If itpasses the Senate, the bill would then have to be reconciledwith the House version and signed by Obama.

Reids plan would cover 94 percent of eligible Americansunder 65, and reduce the deficit by $132 billion over its firstdecade, the Congressional Budget Office estimated.

Health insurers and companies such as medical-device makerMedtronic Inc. of Minneapolis and drugmaker Pfizer Inc. of NewYork would get millions of new customers with the extension ofcoverage. Their industries would also face billions of dollarsin new fees.

Nelson warned that his vote isnt guaranteed if the bill isrevised much in negotiations with the House. If there are bigchanges, I will vote against it, he told reporters.

Americas Health Insurance Plans, the industrys Washingtontrade group, said the bill would increase costs for familiesand small businesses and disrupt the quality coverage on whichmillions of Americans rely today.

Insurers such as Minnetonka, Minnesota-based UnitedHealthGroup Inc. would be required to accept all new clients,regardless of pre-existing conditions and face limits on howmuch revenue can be spent beyond covering medical expenses.

Gone was a new government-run insurance program, or publicoption, designed to compete with private insurers. As analternative, the U.S. Office of Personnel Management, whichoversees benefits for all civilian federal workers and membersof Congress, would contract with private insurers to offermultistate plans on the insurance exchange.

A 383-page amendment Reid offered yesterday made some majorand minor changes to the proposed legislation.

Reid also boosted penalties for companies that dontprovide health insurance. Any company with more than 50employees could face a penalty of $750 per worker, multiplied bythe total number of full-time workers it employs, if just oneobtains subsidized coverage through an exchange. Thats up froma penalty of $400 in an earlier draft.

Reid dropped plans for a tax on cosmetic surgery, dubbedthe Bo-tax, in favor of a 10 percent levy on indoor tanningsalons. And he raised a Medicare payroll tax increase to 0.9percent, from 0.5 percent, on individuals earning more than$200,000 or families making more than $250,000.

Nelson said the language satisfied him, though it drewcriticism from antiabortion groups. The Nebraska lawmaker alsowon another prize, with additional Medicaid costs to his statebeing absorbed by the federal government.

On abortion, the legislation would set up an accountingprocedure to prevent government funds from being used to fundabortions covered by private insurance on the exchanges. Stateswould be able to keep their own prohibitions on abortioncoverage, and the exchanges would have to offer at least oneplan that doesnt cover the procedure.