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Republican senators blocked Democratic legislation on Thursday that sought to provide medical care to rescue workers and others who became ill as a result of breathing in toxic fumes, dust and smoke at the site of the World Trade Center attack in 2001. The 9/11 health bill, a version of which was approved by the House of Representatives in September, was among several initiatives that Senate Democrats had hoped to approve before the close of the 111th Congress. Supporters believe this was their last real opportunity to have the bill passed. The action by the Senate created huge uncertainty over the bill’s future. Its proponents were working on Thursday to salvage the legislation, with one possibility being to have it inserted into a large tax-cut bill that Republicans and Democrats are trying to pass before Congress ends its current session. Such a move seemed unlikely, since it might complicate passage of the tax package, which includes a provision that President Obama sought in return for backing the continuation of tax cuts for all income levels that Republicans wanted: an extension of unemployment benefits. In a vote largely along party lines, the Senate rejected a procedural move by Democrats to end debate on the 9/11 health bill and to bring it to a vote; 60 yes votes were needed, but the move received 57, with 42 votes against. Republicans have been raising concerns about how to pay for the $7.4 billion measure, while Democrats, led by Senator Kirsten E. Gillibrand of New York, have argued that there was a moral obligation to assist those who put their lives at risk during rescue and cleanup operations at ground zero. The bill is formally known as the James Zadroga 9/11 Health and Compensation Act, named after a New York police detective who participated in the rescue efforts at ground zero. He later developed breathing complications that were common to first responders at the site, and he died in January 2006. The cause of his death became a source of debate after the city’s medical examiner concluded that it was not directly related to the attacks. After the vote, Representative Carolyn B. Maloney of New York, a chief sponsor of the bill in the House, argued that Democrats should include the 9/11 health bill in the larger tax-cut legislation and, in the process, dare Republicans to oppose it in that context. Ms. Maloney added that the tax bill was the one piece of legislation that “Republicans won’t leave this town without passing.” As the day wore on, it appeared increasingly unlikely that the Senate would include a provision providing health care for ground zero workers in any tax package it brought to the floor, according to senior Capitol Hill officials. But supporters of the 9/11 legislation said there was a possibility they could persuade Democratic leaders in the House to include it in any tax-cut plan that the chamber approved and win Senate approval during negotiations over differences in measures passed by the two chambers. The Senate action was a blow to sponsors of the bill, who mobilized a network of allies across the political spectrum to lobby on its behalf, including the New York City police commissioner, Raymond W. Kelly, and Mayor Michael R. Bloomberg. Ms. Gillibrand, the chief sponsor in the Senate, even reached out to former President George W. Bush. But her aides say Mr. Bush did not respond to her entreaties. cont. added by: JanforGore