WASHINGTON – Democrats in the U.S. Senate set up a clash with House Republicans that could lead to a partial shutdown of the federal government in the coming week, approving a spending bill Friday that includes funding for President Barack Obama’s health care overhaul — a provision Republicans oppose.

The Senate vote — 54-44 along party lines — kicks it back to the House, where Republican leaders have already said they will not accept the pared-down version of the bill.

If no agreement is reached by Tuesday, the government will be forced into a shutdown that will keep more than a third of federal employees home, disrupting key services and undermining the shaky U.S. economic recovery.

Adding to the uncertainty, House Republicans are divided on their strategy for responding to the Senate bill.

Hard-core conservatives are determined to use the spending legislation as leverage to demolish the 3-year-old health care law, the most significant domestic accomplishment of the Obama administration. But many Republican leaders fear that insisting on the point will backfire and the party will be blamed for a shutdown.

Earlier Friday, many Republican senators joined Democrats in voting to end delaying tactics by two conservative lawmakers trying to derail passage of the spending bill.

The 79-19 vote marked an emphatic defeat for Sens. Ted Cruz and Mike Lee, whose tactics have been criticized as futile by many others in the GOP.

Obama spoke after the vote from the White House, where he said it was up to House Republicans to follow the Senate’s lead and prevent a shutdown. He said the struggle has nothing to do with budget deficits and that if Republicans “have specific ideas on how to genuinely improve the (health care) law rather than gut it, rather than delay it, rather than repeal it, I am happy to work with them.”

He also said even a shutdown would not prevent the scheduled opening of so-called health care exchanges next Tuesday through which millions of Americans will be able to shop for coverage. “That’s a done deal,” Obama said.

The stock market fell Friday for the sixth day out of the last seven. The Dow Jones industrial average fell 70.06 points, or 0.5 percent, to close at 15,258.24. The Standard & Poor’s 500 index fell 6.92 points, or 0.4 percent, to 1,691.75. The Nasdaq composite was down 5.83 points, or 0.15 percent, at 3,781.59. Still, the indexes were off only about 1 percent for the week.

A government closure would affect national parks from California to Maine and all the Smithsonian museums in the nation’s capital. Workers at the State Department’s Bureau of Consular Affairs wouldn’t be around to process visa and passport applications, complicating the travel plans of hundreds of thousands of people.

Washington’s bitterly divided lawmakers have managed to come up with last-minute compromises in recent years to avoid shutdowns. Even so, supervisors at government agencies began meetings Thursday to decide which employees would continue to report to work and which would be considered nonessential and told to stay home under contingency plans. Services considered critical to national security, safety and health would continue operating.

No votes on the budget bill were expected in the House until at least the weekend.

Meanwhile, an even more complicated and potentially dangerous showdown looms ever nearer on the U.S. debt limit. Republican disunity over what to include in that bill has forced leaders to indefinitely delay it. The legislation is required to raise the federal government’s borrowing authority or risk a damaging, first-ever U.S. default that the Obama administration has warned could occur by Oct. 17.

Many analysts think even the serious threat of a federal default would jar the economy — for which neither party would relish being blamed.

On the spending bill, some Republicans want to abandon the effort to kill the health care law and instead insert provisions repealing an unpopular tax on medical devices, or erase federal subsidies for Congress’ own health care coverage. They could then dare the Senate to reject the overall measure — and face the fallout from the government shutdown that would ensue.

But lawmakers and Republican aides cautioned that no decisions had been made, in part because it was unclear whether even those provisions would help win enough votes for House passage.

Asked Thursday whether he envisions the House approving a simple Senate-passed bill keeping the U.S. government open, the leader of the House, Speaker John Boehner, told reporters, “I don’t see that happening.”