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By David Gardner
Victory: President Barack Obam walks to the White House podium to deliver his address with Vice President Joseph Biden Barack Obama hailed the passing of his historic healthcare overhaul today, declaring: 'This is what change looks like.'
The jubilant president was preparing to sign his £600billion plan into law after the House of Representatives passed the bill in a cliffhanger vote.
Speaking from the White House at midnight in Washington, Mr Obama celebrated his triumph in ushering through major reforms 'after nearly 100 years of talk and frustration, after decades of trying and a year of sustained effort and debate'.
He added: 'It's a victory for the American people and it's a victory for common sense.'
A huge cheer went up from House Democrats as the vote reached the 216 mark required to pass the reforms already adopted by the U.S. Senate.
The final tally was 219 to 212.
A short time later, Democrats also drove through a package of amendments by 220 votes to 211 that were agreed to make the bill more palatable for some rank-and-file members.
After going back to the Senate for approval the 'fixes' will be combined into the final legislation.
The rocky passage of the bill, coming after a thwarted mutiny by some Democrats, was seen in Washington last night as one of the most significant legislative triumphs in decades.
'Do it for the American people': President Obama holds a letter from someone in need of health insurance as he addresses the House Democratic caucus And it is a huge vindication for Mr Obama, who made health care reform his top domestic priority and the defining issue of his first year in office, setting off a tumultuous debate that left the country deeply divided.
'Today's vote answers the prayers of every American who has hoped deeply for something to be done about a healthcare system that works for insurance companies but not for ordinary people,' he said.
'We proved that we are still a people capable of big things.
'We answered the call of history as so many generations of Americans have before us,' he added.
'When faced with crisis, we did not shrink from our challenge, we overcame it. We did not avoid our responsibility, we embraced it. We did not fear our future, we shaped it.'
House Speaker Nancy Pelosi paid tribute to the 'extraordinary leadership and vision' of the president.
'It is with great humility and great pride that tonight we will make history for this country,' she said minutes before the vote.
'This is an American proposal that honours the traditions of this country,' she added.
It wasn't until the morning of the vote that Democrat whips in the House of Representatives finally nailed down the votes they needed in the 435-member chamber to prevent a defeat that would have rocked the Obama administration.
Opposition: A few protesters stay outside the Capitol late in the evening as they chant 'Kill the Bill'The president cancelled his planned trip to Australia and Indonesia to lead the arm-twisting and cajoling that carried on right up until the rare make-or-break Sunday congressional session.
Eventually, a key group of Democrats who opposed the bill because they claimed it could open the way for state-funded abortions relented and agreed to vote in favour.
Congressman Bart Stupak, the leader of the rebel faction, voted for the legislation after being promised that Mr Obama would issue an executive order affirming a ban on government cash being used for abortions except in cases of rape, incest or to save the life of the mother.
The reform is likely to be judged alongside the boldest acts of presidents and U.S. Congress in domestic affairs.
While national healthcare has long been the goal of president stretching back decades, it has proved elusive in part because self-reliance and suspicion of government intervention remain strong across America.
When Mr Obama signs the hefty new bill into law it will usher in sweeping changes to the £1.5trillion U.S. healthcare system, including expanding coverage to as many as 32million Americans who are currently uninsured and barring insurance companies from denying coverage in cases where patients have a pre-existing condition.
It will also require most Americans to have insurance, give subsidies to help some pay for coverage and create state-based exchanges where the uninsured can compare and shop for plans.
While smiles replaced the tense frowns of House Democrats after corralling their majority votes, thousands of protesters chanted ‘kill the bill’ outside the Capitol, a clear sign of the considerable opposition to the plan.
Attack: Like his party colleagues, House Republican Leader John Boehner does not want the healthcare bill to passWith all attempts at bipartisanship out of the window, Republicans contend the bill amounts to a government takeover of health care that will lead to higher deficits and taxes.
And they warned Democrat lawmakers they will pay the price at the mid-term elections in November.
'My colleagues shame us,' said Congresswoman Marsha Blackburn.
'Freedom dies a little bit today. Unfortunately, some are celebrating.'
House Minority Republican Leader John Boehner said he had a 'sad and heavy heart.'
'We stand here amidst the wreckage of what was once the respect and honour that this House was held in by our fellow citizens and we all know why is it so - we have failed to listen to America. We have failed ourselves and failed our country,' he added.
But Mr Obama rallied Democrats on Saturday, telling them: ‘I know what pressure you are under. This is one of those moments. 'This is one of those times where you can honestly say to yourself, ’Doggone it, this is exactly why I came to Congress.
‘Don’t do it for me, don’t do it for the Democratic Party, do it for the American people. They’re the ones looking for action right now,’ he added.
The Democrats hold 253 seats in the House of Representatives, compared to 178 Republicans, and needed 216 votes to prevail.
The reason there were two votes - one on a bill that has already passed through the Senate and another on a package of 'fixes' - was so that amendments could be included that appeased Democrats worried about some aspects of the narrower Senate version passed on Christmas Eve.
While the rubber-stamped Senate bill went to the White House to become law, the amendments are being sent back to the Senate for approval.
Senate Democrats say they are confident of the simple 51-majority in the 100-member chamber required to pass the amendments within days.
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