By DAVID M. HERSZENHORN, The New York Times

When Senate Democratic leaders first went behind closed doors to complete the health care legislation, the only women in the room were either committee staff members or officials from the White House. The senators there — Harry Reid of Nevada, Max Baucus of Montana and Christopher J. Dodd of Connecticut — reflected the Senate’s predominant history as an old-boys’ club.

But to move the bill forward for full debate, the Democrats’ last two crucial votes came from women: Senators Mary L. Landrieu of Louisiana and Blanche Lincoln of Arkansas.

And when it comes time for the final consideration of the bill, two other women may cast similarly crucial votes: Senators Susan Collins and Olympia J. Snowe, Maine Republicans who are expected to be courted heavily by Democrats and the White House.

Controversial issues in the Senate often do not get resolved until a bipartisan “gang” is formed to strike a deal. And as the health care debate heads into the final stretch, there is the possibility of this women’s Gang of Four calling the shots.

If it happened, it would reflect women’s rising power in the Senate more generally.

Of the 17 women in the Senate, 13 are Democrats. And four of the Democrats are committee chairwomen: Barbara Boxer of California on Environment and Public Works, Dianne Feinstein of California on Intelligence, Mrs. Lincoln on Agriculture and Ms. Landrieu on Small Business and Entrepreneurship. Mrs. Boxer also leads the Ethics Committee.

All four Republican women are senior members of committees.

Senator Barbara A. Mikulski of Maryland, who by dint of seniority is the self-declared “dean of the Democratic women in the Senate,” emphasized the importance of health care to women in a speech earlier this fall.

“Health care is a women’s issue,” Ms. Mikulski said. “Health care reform is a must-do women’s issue, and health insurance reform is a must-change women’s issue.”

To read the full article, visit: http://prescriptions.blogs.nytimes.com/