WASHINGTON — Senators gave President Barack Obama a huge political boost by passing a sweeping remake of the US health care system that aims to extend coverage to 31 million uninsured Americans.
A feverish atmosphere prevailed in the storied Senate chamber as one of the most important pieces of social legislation in decades was passed by a 60-39 vote that strictly followed party lines.
"Ever since Teddy Roosevelt first called for reform in 1912, seven presidents -- Democrats and Republicans alike -- have taken up the cause of reform," Obama said after the vote.
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"Time and time again, such efforts have been blocked by special interest lobbyists who've perpetuated a status quo that works better for the insurance industry than it does for the American people.
"But with passage of reform bills in both the House and the Senate, we are now finally poised to deliver on the promise of real, meaningful health insurance reform that will bring additional security and stability to the American people."
The legislation ushering in a 10-year, nearly one-trillion-dollar reform program must now be reconciled with a separate House of Representatives version before going to Obama's desk to be signed into law early next year.
Attention now focuses on negotiations to forge a compromise between the two bills, with Republicans hopeful that differences over key provisions might lead to damaging Democratic infighting ahead of crucial 2010 mid-term elections.
But Democrats were united and celebrating victory after months of tough maneuvering on a hot-button political issue that Obama had made his top domestic priority.
The Republican Party had sought to kill the bill or at least delay the battle well into 2010, when the legislative elections would have made it more difficult for centrist Democrats to support the reforms.
No Republican senator voted for the health care package.
Senate Republican Minority Leader Mitch McConnell's reaction summed up the bitterness throughout a months-long political battle, which earlier this summer saw Obama under fire at a series of angry town hall meetings.
"I guarantee you the people who voted for this bill are going to get an earful when they finally get home for the first time since Thanksgiving. They know there is widespread opposition to this monstrosity," McConnell said.
"This fight isn't over. My colleagues and I will work to stop this bill from becoming law. That's the clear will of the American people and we're going to continue to fight on their behalf."
But Obama, hours before departing for Hawaii on his Christmas break, hailed the "historic vote" and vowed to "finish the job."
"With today's vote we are now incredibly close to making health insurance reform a reality in this country," he said.
"We can't doom another generation of Americans to soaring costs and eroding coverage and exploding deficits. Instead, we need to do what we were sent here to do and improve the lives of the people we serve."
The headline battle looms over the provision of a government-backed "public option" to compete with private insurers. This measure was stripped from the Senate bill but remains in the House version.
Another potential problem is the House bill's tougher restrictions on federal funds subsidizing abortions: while pro-choice lawmakers denounce the limits, centrist Democrats say they will withhold support without them.
Centrist senators have also warned that they will doom the measure if the compromise talks lead to drastic changes to the Senate's hard-won compromise.
Obama rebuts critics who say the United States, recovering from a painful recession and with double-digit unemployment, cannot afford the reforms that will extend coverage to 31 million of the 36 million Americans who lack it now.
He points to estimates from the Congressional Budget Office (CBO), which found the bill would reduce the federal deficit by 132 billion dollars over the first 10 years and as much as 1.3 trillion in the next decade.
The United States is the world's richest nation but the only industrialized democracy that does not provide health care coverage to all of its citizens.
As a nation, the United States spends more than double what Britain, France and Germany do per person on health care.
But it lags behind other countries in life expectancy and infant mortality, according to the Organization for Economic Cooperation and Development (OECD).