The US House of Representatives has approved the broadest overhaul of US health care in four decades, handing President Barack Obama a hard-fought victory for his top domestic priority. Heeding Obama's appeal to "answer the call of history," lawmakers late Saturday capped 12 hours of bitter debate with a 220-215 vote.
The bill amounts to a 10-year, trillion-dollar plan to extend health coverage to some 36 million Americans who lack it. "Tonight, in an historic vote, the House of Representatives passed a bill that would finally make real the promise of quality, affordable health care for the American people," Obama said in a statement.
The fight to remake health care in the world's richest country shifted to the US Senate, where its fate remained unclear amid a tense intra-party dispute among Democrats anchored on what role the US government should play.
Obama said he was "absolutely confident" the Senate would pass its own bill, stressing: "I look forward to signing comprehensive health insurance reform into law by the end of the year." House Speaker Nancy Pelosi, who has faced tough criticism from Republicans over the proposal, said the health care bill "improves quality, lowers cost, expands coverage to 36 million more people and retains choice."
But Republican Minority Leader John Boehner said the measure amounts to a government take-over of the health care industry "that increases costs, adds to our skyrocketing debt" and "destroys jobs with tax hikes and new mandates." If, as expected, the House and Senate pass rival versions of health care legislation, they will need to thrash out a compromise version and approve it in order to send it to Obama to sign into law, a frequently tough process.
Obama and Democratic House leaders had invested heavy political capital in what they knew would be a close contest sure to shape his legacy and the fate of his ambitious plan to remake US health care if the bill went down to defeat.
The president telephoned wavering members on Friday and paid a rare visit to Congress on Saturday, buttressed with a speech from the White House Rose Garden, but still 39 Democrats joined 176 Republicans to oppose the plan.