Republicans said they would resist the legislation with every tool available, and they denounced the deal struck on Saturday. “This process is not legislation,” said Senator Tom Coburn, Republican of Oklahoma, referring to a variety of special-interest provisions. “This process is corruption. It’s a shame the only way we can come to a consensus in this country is to buy votes.”

Mr. Baucus defended the assistance for those affected by the asbestos site in his state. “The people of Libby were poisoned and have been dying for more than a decade,” he said. “New residents continue to get sick all the time. Public health tragedies like this could happen in any town in America. We need this type of mechanism to help people when they need it most.”

Items were inserted into the bill by the Senate majority leader, Harry Reid, Democrat of Nevada, to get or keep the support of various lawmakers. He needs support from all 60 members of his caucus to overcome a Republican filibuster and pass the bill by his self-imposed Christmas deadline.

Senator Ben Nelson, Democrat of Nebraska, was the critical final Democrat to endorse the bill. He obtained tighter restrictions on insurance coverage of abortion, and additional Medicaid money and other benefits for his state.

Another item in the package would increase Medicare payments to hospitals and doctors in any state where at least 50 percent of the counties are “frontier counties,” defined as those having a population density less than six people per square mile.

And which are the lucky states? The bill gives no clue. But the Congressional Budget Office has determined that Montana, North Dakota, South Dakota, Utah and Wyoming meet the criteria.

Image Senators Max Baucus, left, Harry Reid and Christopher J. Dodd at a news conference on Saturday. Mr. Reid, the majority leader, needed all 60 members of his caucus to back the health bill. Credit... Brendan Smialowski for The New York Times

Another provision would give $100 million to an unnamed “health care facility” affiliated with an academic health center at a public research university in a state where there is only one public medical and dental school.