In a historic move, the House of Representatives voted by a margin of 219 to 212 to extend health care to millions of uninsured Americans.
The reform effort, which survived months of negotiations and the Democrats' loss of their filibuster-proof majority in the Senate, is becoming law through a process known as reconciliation.
President Obama intends to sign the measure on Tuesday.
After approving the bill, the House adopted a package of changes to it by a vote of 220 to 211. That package -- agreed to in negotiations among House and Senate Democrats and the White House -- now goes to the Senate for a vote. It will be the final step in a bitter legislative fight that has highlighted the nation's deep political and philosophical divisions.
However, the health care bill did not pass the House without controversy. Thousands of protesters gathered in the nation's capital to rally against reform, and Republicans were united in their opposition to the bill. Many Republicans are vowing to fight for the legislation's repeal after it becomes law.
"It is with great humility and great pride that we will make history for our country and progress for the American people... Just think, we will be joining those who established social security, Medicare, and tonight, health care for all Americans." - House speaker Nancy Pelosi (D-Calif.)
"This is the people's house. And the moment a majority forgets that, it starts writing itself a ticket to minority status." - House minority leader John Boehner (R-Ohio)
"We have a moral obligation, today, tonight, to make health care a right and not a privilege [....] we cannot wait, we cannot be patient, the American people need health care and they need it now." - Rep. John Lewis (D-Ga.)
"The American people have spoken. They do not want the tentacles of the federal government reaching into their lives and making their health care decisions [...] I urge my colleagues to listen to the American people and kill the bill." - Rep. Dave Camp (R-Mich.)
1. What is the U.S. House of Representatives?
2. In general, what steps must be followed for a bill to become law?
3. What are the two main political parties in the House of Representatives? Which party was united against this health care bill?
1. Why is this health care reform process so controversial? What were protesters angry about?
2. Do you think the House's passage of this health care reform bill is a good thing? Why / why not?
3. What makes this vote historic?
4. In this situation, what steps were and must still be taken for this bill to become law? How does the reconciliation process work?
5. What problems do you think this health care bill will address? What problems do you think will still be unresolved after the bill becomes law?