When H.R. 6675 reached the floor, it was the first time that a Social Security-based health plan had been debated in the House of Representatives. Republicans continued to fight for a fully voluntary health plan and opposed the universal, Social Security-approach that was the centerpiece of the bill. The minority proposed an alternative bill based on the Byrnes bill that was narrowly defeated 236 to 191, with 128 of 138 Republicans in favor of the substitute. The April 8, 1965 roll call vote on H.R. 6675, however, was a more bipartisan 313 to 115. A House clerk recording this historic vote tallied the “yea” votes with an upward mark by the name of the member, while “nay” votes are indicated by a downward mark.