WASHINGTON: The US House of Representatives has approved the broadest overhaul of US health care in four decades, handing President Barack Obama a hard-fought victory for his top domestic priority.

Heeding Obama’s appeal to “answer the call of history,” lawmakers last evening capped 12 hours of bitter debate with a 220-215 vote.

The bill amounts to a 10-year, trillion-dollar plan to extend health coverage to some 36 million Americans who lack it.

“In an historic vote, the House of Representatives passed a bill that would finally make real the promise of quality, affordable health care for the American people,” said Obama.

The fight to remake health care in the world’s richest country shifted to the US Senate, where its fate remained unclear amid a tense intra-party dispute among Democrats anchored on what role the US government should play. Obama said he was “absolutely confident” the Senate would pass its own bill, stressing: “I look forward to signing comprehensive health insurance reform into law by the end of the year.” House Speaker Nancy Pelosi, who has faced tough criticism from Republicans over the proposal, said the health care bill “improves quality, lowers cost, expands coverage to 36 million more people and retains choice.” But Republican Minority Leader John Boehner said the measure amounts to a government takeover of the health care industry “that increases costs, adds to our skyrocketing debt” and “destroys jobs with tax hikes and new mandates”.