Tempers continued to flare on the Senate floor Tuesday as floor debate on the Patient Protection and Affordable Care Act bill, H.R. 3590, continued for a second day.

Republicans continued to argue that H.R. 3590 would cut Medicare funding by about $500 billion over 10 years, that it would create big new government programs, and that it’s 2,074 pages long.

Democrats continued to argue that the bill would provide Americans with desperately needed help with paying for health care, and that the Republicans have not come up with a realistic alternative to their bill.

“I wish I could compare it to the Senate Republican alternative, but that does not exist,” said Sen. Richard Durbin, D-Ill.

Republicans and Democrats also continued to debate whether Democrats had given Republicans enough of a chance to shape the PPACA bill and whether Democrats were treating Republican lawmakers politely.

Sen. John McCain, R-Ariz., who has introduced a motion that calls for the Senate to send H.R. 3590 back to the Senate Finance Committee with instructions to rewrite the Medicare funding cut provisions, complained that Durbin had failed to yield the floor to let him respond to the accusation that Republicans had not made a serious effort to develop patient protection proposals of their own.

Durbin apologized to McCain for not yielding the floor.

McCain noted that he had fought with Sen. Edward Kennedy, D-Mass., for years on behalf of patient protection proposals.

Sen. Thomas Coburn, R-Okla., defended the Medicare Advantage program, noting that it provides an affordable alternative to the Medicare supplement insurance that higher-income patients can afford to buy to fill holes in traditional Medicare program benefits.

Congress can and should find ways to make Medicare Advantage more efficient, but it should try to do that without cutting the benefits that plan participants depend on, Coburn said.

One way to make Medicare more efficient would be to for Medicare to use the same kinds of coverage precertification requirements that private plans use, rather than keeping the current “pay and chase” approach to retrieving overpayments, Coburn said.

Sen. Thomas Harkin, D-Iowa, rejected Republican criticisms of the PPACA bill and said the bill includes many provisions that will protect Medicare beneficiaries and strengthen the program’s solvency.

Harkin noted that Republicans have had a long history of trying to cut Medicare, and he recalled that former House Speaker Newt Gingrich, R-Ga., had suggested that Medicare ought to “wither on the vine.”

“Talk about crocodile tears,” Harkin said.

Sen. James Bunning, R-Ky., later conceded that people ought to have health insurance but objected to the idea of the government requiring people to buy coverage.

Bunning also argued that the Republicans have developed good alternatives to the PPACA bill.

“We have a bill,” Bunning said. “We just don’t have a 2,000-page bill like they do.”

Ordinary voters “think we are losing our fiscal minds,” said Sen. Jefferson Sessions, R-Ala.

Democrats were hoping to have lawmakers vote early this evening on a women’s health benefits amendment; a Medicare amendment to be offered by Senate Majority Harry Reid, D-Nev., who created the PPACA bill by melding health bills developed by the Senate Finance Committee and the Senate Health, Education, Labor and Pensions Committee; and the McCain motion to send the bill back to the Finance Committee.

As of 7:20 p.m., Republicans were still waiting their turns to talk about the bill, and lawmakers were still waiting to vote on the amendments and McCain’s motion.

For more coverage of the Senate health bill, see these stories: