Washington: The House of Representatives passed a sweeping health care bill Saturday night with a tight vote of
220-215, making it the biggest expansion of health care coverage since Medicare was created more than 40 years ago.
The Affordable Health Care for America Act, or H.R. 3962, restricts insurance companies from denying coverage to anyone with a pre-existing condition or charging higher premiums based on gender or medical history. It also provides federal subsidies to those who cannot afford it and guarantees coverage for 96 percent of Americans, according to the nonpartisan Congressional Budget Office.
However, turning the bill into law remains uncertain.
The bill barely squeaked by in the Democrat-controlled House, with just one Republican voting for it -- first-time lawmaker Joseph Cao who holds a seat in predominantly Democratic New Orleans.
One hundred and seventy-six Republicans opposed it, as did 39 Democrats.
The Senate must now pass its own version of the health care legislation.
Senate lawmakers are also having a hard time winning over Republicans and conservative Democrats. It is unclear when the Senate will vote on its version.
Even if it passes, lawmakers in the House and Senate will have to reconcile their respective versions into one document and vote again.
President Obama said he was "absolutely confident" the Senate will follow suit in passing its version of the bill.
"I look forward to signing comprehensive health insurance reform into law by the end of the year," he said.
With eight seconds left in the voting period, Democrats began counting down, erupting in roars when House Speaker Nancy Pelosi declared, "The bill is passed."
Democrat Sheila Jackson-Lee from Texas waved a copy of the bill while her colleagues pumped their fists.
"Democrats voted for the bill and a Republican voted for the bill. That equals bipartisan," Pelosi said later.
Republican lawmakers stood silently across the floor, some with their arms folded across their chest.
"Well, it was about what I thought it would be," said House Republican Leader John Boehner of Ohio as he quickly exited.
Later, he issued a statement where he said the $1.2 trillion legislation would add to the country's "skyrocketing" debt. Democrats have said the bill will cut the deficit by $104 billion over 10 years.
"I came here to renew the American Dream, so my kids and their kids have the same opportunities I had," Boehner said. "I came here to fight big-government monstrosities like this bill that dim the light of freedom and diminish opportunity for future generations."
Michael Steele, the chairman of the Republican National Committee, released an equally tersely-worded statement.
"Nancy Pelosi and her liberal lieutenants made a lot of promises today to get the votes they desperately needed," he said. "Make no mistake -- the Democrat leadership's assurances were based on political expediency, not principle. Anyone receiving a promise from Pelosi is guaranteed to be disappointed in the end when their votes are no longer needed."
Earlier in the day, Obama met behind closed doors with Democrats to shore up support for the bill, calling it a chance of a generation.
In the run-up to the vote, Republicans and conservative Democrats joined forces to pass an amendment to the bill to prohibit federal funds for abortion services.
Its consideration was considered a big win for them and the U.S. Conference of Catholic Bishops, which used its power, especially with conservative Democrats in swing congressional districts, to help force other Democratic leaders to permit a vote that most of them oppose.
The prohibition, introduced by Democratic members, including Rep. Brad Ellsworth of Indiana and Rep. Bart Stupak of Michigan, would exclude cases of rape, incest or if the mother's life is in danger.
The GOP accounted for 174 of the votes in favor of the amendment, with one Republican voting "present."
On the Democrat's side, 64 voted for the measure, and 194 voted against.
A second amendment, introduced by Boehner, would have substituted several sections of the health care bill dealing with insurance. Legislators voted against the amendment 258-176.
Rep. John Dingell of Michigan, the longest-serving member of the House, presided over the debate. Since joining the House in 1955 to replace his father, Dingell, 83, has introduced his father's health insurance bill every year since.
"The nation will be grateful to us all," he said, urging the House to pass the bill.
It did, after a lengthy contentious session. Later, the Democrats made it clear they are braced for a fight if one awaits them in the Senate.
"Today, Congressional Democrats put opponents of reform on notice: the status quo is unsustainable and inaction is not an option," said Tim Kaine, the chairman of the Democratic National Committee. "This vote doesn't mark the end of this process -- we still have a ways to go -- but it is a critical milestone on the road to passing health insurance reform.
"The American people want reform -- they need reform -- and Democrats will not rest until we pass comprehensive health reform legislation."
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