**The US House of Representatives has narrowly voted to pass a landmark healthcare reform bill at the heart of President Barack Obama’s agenda.**The bill passed by 219 votes to 212, with no Republican backing, after hours of fierce argument and debate.
It extends coverage to 32 million more Americans, and marks the biggest change to the US healthcare system in decades.
The Republicans say the measures are unaffordable and represent a government takeover of the health industry.
Lawmakers held two votes into the late hours of Sunday - the first on procedural issues, and the second to pass a Senate version of a health reform bill.
Mr Obama is expected to sign the legislation into law shortly.
Long road
ANALYSIS
Mark Mardell, BBC News, Washington
Emotions have been running high at times with Republicans warning of government tyranny, a European-style “nanny state” and an end to freedom. Equally emotional speeches from the other side talked about “healing America”. But the real work was going on behind the scenes to secure the last necessary votes. Negotiations had been going on for several days with Bart Stupak, who leads anti-abortion Democrats. He won an executive order to be signed by the president once the vote has taken place.
Read Mark’s thoughts in full
In a last-minute move designed to win the support of a bloc of anti-abortion lawmakers, Mr Obama earlier on Sunday announced plans to issue an executive order assuring that healthcare reform will not change the restrictions barring federal money for abortion.
The House must now vote on a package of reconciliation “fixes” sought by some Democrats to the legislation.
If the House approves the package of changes to the Senate bill, the Senate would take it up next week using a procedure known as reconciliation.
That would allow budget provisions to be approved with 51 votes - rather than the 60 needed to overcome blocking tactics.
According to the Congressional Budget Office, the final version of the Democrats’ healthcare plan will cut the federal deficit by $138bn (£92bn) over 10 years.
The non-partisan body said the proposed legislation would cost about $940bn (£626bn) over a decade.
The reforms will increase insurance coverage through tax credits for the middle class and expansion of the Medicaid programme for the poor.
They represent the biggest change in the US healthcare system since the creation in the 1960s of Medicare, the government-run scheme for Americans aged 65 or over.