ABC's Z. Byron Wolf reports: Gone are the days when Sen. Jim Bunning could be publicly shamed for standing in the way of an unemployment benefit, COBRA subsidy and Medicare doctor pay extension. Bunning got no support from his colleagues and a fair amount of public derision back in March when he stood alone in the way of a temporary extension of emergency federal unemployment benefits, COBRA subsidies for the laid-off and to keep Medicare doctors from getting a pay cut because he said the spending needed to be offset elsewhere in the budget. Subsequent temporary extensions got increasingly more support from Republicans, who wanted to offset that spending elsewhere in the budget. And today, when Senators voted on a proposal to extend benefits through the end of the year as part of a larger package of tax measures, only 44 Democrats and one Independent voted to waive budget rules and proceed with the bill – not even simple majority, and much less the 60 votes that Democrats needed. Read the report on what all is in the bill, prepared by Democrats, HERE. The most recent temporary extension ran out two weeks ago. The federal agency that runs Medicare has told contractors to hold doctor payments through this coming Friday, which means the 21 percent Medicare doctor pay cut could start next week. Democrats in Congress have been sparring amongst themselves over how to get the bill through both the House and the Senate. In the House, conservative Blue Dog Democrats oppose any deficit spending. The bill rejected today in the Senate would have added more than $80 billion to the debt over ten years. Most Democrats say the spending is to deal with the economic emergency and so should not be ofset. What now? Democrats in the Senate may attempt to shrink unemployment benefits by $25 per month for the out-of-work and shorten the “Doc Fix,” which stalls a pay cut to Medicare doctors, to bring down the overall cost of the bill and mollify moderates concerned about the deficit. But whatever deal they has out in the Senate will ultimately have to satisfy House Democrats too.