The 219-212 vote marks the biggest victory yet for President Barack Obama, who will soon sign the bill into law. Only Democrats voted for the legislation, underscoring a partisan divide that promises to make health care the defining issue in November's congressional elections....

To get it done, House Democrats approved a Senate bill passed in December while preparing for another vote on a measure that would amend the Senate legislation to fix provisions they don't like. The Senate must also pass this second bill under a budget process called reconciliation that requires a simple majority vote. The chamber plans to act next week.

Total Costs

The two bills together will cost $940 billion over 10 years and cover 32 million uninsured Americans, the Congressional Budget Office estimated. That's more than made up for with a new tax on the highest earners, fees on health-care companies and hundreds of billions of dollars in Medicare savings, which will reduce the federal budget deficit, the CBO said.

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The Act maintains current Hyde Amendment restrictions governing abortion policy and extends those restrictions to the newly-created health insurance exchanges.  Under the Act, longstanding Federal laws to protect conscience (such as the Church Amendment, 42 U.S.C. §300a-7, and the Weldon Amendment, Pub. L. No. 111-8, §508(d)(1) (2009)) remain intact and new protections prohibit discrimination against health care facilities and health care providers because of an unwillingness to provide, pay for, provide coverage of, or refer for abortions.

WASHINGTON -- The House of Representatives late Sunday passed by a 219 to 212 vote the biggest overhaul of the nation's health care system in more than four decades, sweeping changes expected to make coverage easier and cheaper to obtain.

The largely party-line vote -- 219 Democrats voted "yea," while all 178 Republicans and 34 Democrats voted no -- meant President Barack Obama's biggest domestic initiative inched closer to the end of its year-long political and legislative odyssey.

The vote sent a bill passed on Dec. 24 by the Senate to Obama for his signature. The House, however, will consider later Sunday another bill that would make major changes, called reconciliation.

If that passes -- and approval seems virtually assured -- it would go to the Senate immediately. Should the Senate concur, probably later this week, all the health care changes would need is Obama's certain signature.

The $940 billion legislation would make the biggest health care since Medicare was created 45 years ago. Under the new plan, most consumers would be required to have coverage by 2014, and most employers would have to offer it.