Obama's health reforms approved
US President Barack Obama's hopes of achieving landmark US health reforms have received a big boost after approval by the House of Representatives. Hailing it as “historic, he said that the sweeping reforms would see healthcare coverage extended to 36 million more Americans.
The bill was passed by the US House of Representatives and Barack Obama immediately hailed it "an historic vote".
And the changes – passed on a narrow 220-215 vote – are the most significant for four decades.
As well as extending affordable healthcare to nearly all Americans, the bill bars insurance practices such as refusing to cover people with pre-existing medical conditions.
Obama's top domestic priority now moves to the US Senate, where work on its own version has stalled for weeks.
Any differences between the Senate and the House bills will have to be reconciled, and a final bill passed again by both before going to Obama for his signature.
The President said: "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.
"Thanks to the hard work of the House, we are just two steps away from achieving health insurance reform in America.
"Now the United States Senate must follow suit and pass its version of the legislation.
"I am absolutely confident it will, and I look forward to signing comprehensive health insurance reform into law by the end of the year."
House speaker Nancy Pelosi was cheered by Democrats as she announced the vote.
The bill aims to extend coverage to 36 million more Americans and provide affordable healthcare to 96%.
Democratic Senators must now consider their own bill. They need 60 out of 100 votes to bring it to a final vote.
There are only 57 Democrats and two independents in the Senate. Two Republicans have signalled they could approve a compromise health bill.
If it is passed, lawmakers from both houses will try to reconcile the two versions before the programme can be signed into law by the president.
In Saturday's vote, the bill was supported by 219 Democrats and one Republican – Joseph Cao from New Orleans. Opposed were 176 Republicans and 39 Democrats.
Key provisions:
- Aims to provide affordable healthcare to 96% to redress 2008 figure of 47 million uninsured
- Individuals must obtain coverage and most firms must provide it to workers
- Creates an insurance market for purchase of coverage
- One product will be a government health insurance plan
- People with pre-existing health problems cannot be denied insurance
- Funded by raft of measures, including 5.4% surtax on those earning $500,000 a year or more
- Those who earn up to 150% of poverty level to qualify for Medicaid government programme for the poor
- Insurers must justify increases in premiums
But Republican representative Candice Miller said: "We are going to have a complete government takeover of our healthcare system faster than you can say 'this is making me sick'."
Before the vote, Obama had made a rare visit to Congress to try to persuade wavering members of his own Democratic Party to back the bill.
He said such opportunities came around "maybe once in a generation".
After the vote House Speaker Nancy Pelosi said: "I thank the president for his tremendous leadership, because without President Obama in the White House, this victory would not have been possible."
The bill will allow the government to sell insurance in competition with private companies and make insurers offer cover to those with pre-existing conditions.
One key concession to get the bill through was to anti-abortion legislators.
An amendment was passed that prohibits coverage for abortion in the government-run programme except for rape, incest or if the mother's life is threatened. Private plans can still offer the cover.
Democrat Bart Stupak, who sponsored the amendment, said: "Let us stand together on principle - no public funding for abortions."
Abortion rights supporters said the amendment was the biggest setback to their cause in decades.
The Senate debate on healthcare reform is expected in the coming days.
Senate majority leader Harry Reid said after the House vote: "We realise the strong will for reform that exists, and we are energised that we stand closer than ever to reforming our broken health insurance system."
