WASHINGTON: The US Congress narrowly passed an historic health overhaul, taking the United States closer to universal medical care and handing Barack Obama the biggest triumph of his presidency. After weeks of behind the scenes wheeler-dealing and bitter debate, the Democrat-held House of Representatives voted 219-212 late Sunday to approve a bill extending health coverage to 32 million more Americans in the most sweeping social policy shift in four decades. “Tonight we answered the call of history as so many Americans have before us. We did not avoid our responsibility we embraced it. We did not fear our future, we shaped it,” Obama said after the vote. No Republicans voted for the bill, already passed by the Senate, and they have warned that Obama will face a political backlash for the measure which will cost hundreds of billions of dollars over the next decade. But the president, who was expected to sign the bill into law within days, praised lawmakers for defying the predictions that the mammoth legislation would collapse in the face of political setbacks and unyielding partisan rifts. Tired after a week in which he met or spoke to nearly 100 lawmakers, but evidently savoring the hard-fought triumph on his top domestic goal, Obama told the US public: “This is what change looks like.” As the vote count crept past the 216 needed to ensure passage, Democrats clapped, cheered, hugged and called out Obama’s “Yes, we can” 2008 campaign slogan. All 178 Republicans and 34 conservative Democrats opposed the measure, spurred on by hundreds of protesters who chanted “Kill the bill” during a loud day-long vigil outside the Capitol. With Vice President Joe Biden at his side, Obama acknowledged Republican warnings that Democrats would pay a steep political price in November mid-term elections that will decide control of Congress. “I know this wasn’t an easy vote for a lot of people. But it was the right vote,” said the president, who has vowed to help Democrats in swing districts win re-election. The Senate now takes up a free-standing package of changes, which the House approved 220-211, as early as Tuesday in a bid to complete its work on the overhaul. Together, the Senate bill and changes would remake US health care a century after President Teddy Roosevelt called for a national approach, extending coverage to 95 per cent of the under-65 population. The bill bans insurance company practices like denying care for preexisting conditions, imposing lifetime caps on coverage, while providing subsidies to buy private insurance in newly-created marketplaces called “exchanges.” It also raises some taxes on the wealthy while expanding a government-run program for needy Americans.