The governor said his main concern is passing legislation that would provide health insurance protection for the 600,000 people currently without such coverage in the state.

"Is there any evidence that the Republican Party in this state and its leadership care about this or has an alternative? I know of none," Dukakis said.

"I think the idea of having every citizen have some sort of insurance to protect them is a good one," Shamie said, but he provided no specific alternatives to the current plan.

Earlier in the day, the influential Massachusetts Hospital Association staged a Statehouse rally for about 300 people and announced its directors voted unanimously to support the governor's bill, which would provide more than $900 million in new revenue to hospitals over the next four years.

A host of amendments were considered yesterday, most of them Republican-sponsored and most of them defeated during debate in a near-empty chamber.

Among those amendments passing was a provision by Voke striking language in the bill that some feared would eliminate a state ban on allowing doctors to bill Blue Shield patients for more than the insurer allowed.

Other approved amendments would require individuals covered by state insurance under the plan to register for the state Employment and Training program, allow individuals getting off welfare to continue to carry Medicaid coverage for two years and to provide for a study into the "flight of physicians" from Massachusetts because of low insurance reimbursements.

Among the amendments that failed was a provision to exempt cities and towns from the insurance mandate. Proponents conceded they did not know of any municipalities not offering health insurance coverage already.