Leaders in the U.S. Senate are now trying to come up with a version of the health care reform bill that could get the support of 60 Senators, enough to start debate on the bill and help shut that debate down when it's time to vote.

A vote may or may not come before the end of the year in the Senate.

The vote in the U.S. House of Representatives this weekend was 220-215.

"I thought it was remarkable that the vote was so close given the substantial majority that the Democrats maintain in the House," Mountain State Blue Cross Blue Shield President Fred Earley said on Monday's MetroNews Talkline.

His company is the largest private insurer in West Virginia.

Earley says he has a number of issues with the House's version of the bill.  "There are a lot of areas still that are very problematic, a lot of places where it'll actually raise the cost of insurance, health insurance, for people as opposed to lowering it."

First District Congressman Alan Mollohan and Third District Congressman Nick Rahall voted for the proposed bill.  Second District Congresswoman Shelley Moore Capito voted against it.

"We're looking at a time here when we have 10.2% unemployment rising....I don't think this is the time to put on a $1.2 trillion (over ten years) plan," Congresswoman Capito said on Monday.  "I have grave concerns about the price tag."

The Senate is not expected to readily approve what the House has done.

One of the biggest issues is that the House version includes a public option for health care coverage for those who cannot afford it, something the Senate Finance Committee's version of the legislation leaves out because there was not enough support for it.

In both plans, preexisting conditions are eliminated and everyone is required to have health care insurance.

However, the House plan requires employers to provide coverage, while the Senate's does not.  The House would pay for coverage expansion by raising taxes on those who make the most money while cutting Medicare.  The Senate plan relies on a series of taxes and fees, including those on the most high end insurance plans.

The estimated cost on the House plan is $1.2 trillion over a decade.  Estimates put the cost of the Senate bill at $900 billion.