Senate Minority Leader Mitch McConnell of Kentucky called provisions inserted to woo Nelson's vote a "kind of smelly proposition."
"This is supposed to be all of our health care ... not just for them," he said at a Capitol Hill press conference.
It was not just Nelson's home state of Nebraska that won concessions in closed-door negotiations, but because Nebraska's carve-out is permanent, the conservative Democrat is catching the most fire from Republicans.
Vermont and Massachusetts will also benefit from special treatment in how the federal government subsidizes state Medicaid programs, although supporters argue that those two states were being penalized because they already help provide insurance for nearly all of their citizens.
Republicans vowed to delay a final vote until Christmas Eve, even though the vote this morning effectively broke their filibuster of health reform legislation.
Why is the GOP fighting it when the passage looks clear for Democrats?
"Because they [Senate Democrats] haven't got the American public," McCain said. "They had 60 percent of the United States Senate, 60 percent of the American people are against this. They want it stopped and they certainly -- as they find out more about this unsavory process we've been through, the Cornhusker Kickback, the Louisiana Purchase, the Florida FlimFlam and all of the other kinds of dealing that went on -- they'll find it very distasteful."
As for whether the late Sen. Ted Kennedy, who had fought for health care overhaul much of his Senate career, would approve, McCain said his friend would not like the the partisan nature of the legislation.
"I think that Senator Kennedy would appreciate the outcome," he said. "I don't think he would appreciate it on a party-line vote. There has never been a major reform accomplished in the history of this country that wasn't bipartisan. ... He never engaged in this kind of unsavory process of offering people different deals, which in the end cost people from other states lots of money and puts burdens on them."
Other goodies were tougher to trace. The bill authorizes $100 million for hospital construction for a medical school opaquely described as "an academic health center at a public research university in the United States that contains a State's sole public academic medical and dental school."
Eleven hospitals would potentially qualify for some of the money, according to Democratic staffers. But the Secretary of Health and Human Services would be in charge of doling the funding out.
On the Senate floor, Sen. Lindsay Graham of South Carolina said the Democrats had to "cook up a deal in a back room that is sleazy in my view."
Republicans would never do that sort of back-room negotiating of a bill of this scope, Graham said.
"We're not going to put the whole nation at risk and take a broken system and make it worse just to get a vote," Graham said. "No way in hell."
"This process is not legislation. This process is corruption," said Sen. Tom Coburn, R-Okla. "It is a shame that the only way we can pass this legislation is to buy votes."
McConnell said Republicans will insist on using all their parliamentary time even after that vote, when it is clear that the bill will pass. If Republicans insist on all their time for debate, a vote on final passage of the bill is likely to occur at 7 p.m. on Christmas Eve.