Democrats hope that once the voters see the law taking effect they will like it

Democrats have hailed the approval of legislation extending healthcare to an additional 32 million Americans as a historic advance in social justice.

The speaker of the House of Representatives, Nancy Pelosi said it was comparable to the establishment of Medicare and Social Security.

The bill was passed in the House on Sunday evening by just seven votes.

Republicans have vowed to continue to challenge it, saying it is too expensive and promotes big government.

Senator John McCain, the defeated presidential candidate, warned that outside the capital “the American people are very angry”.

“They don't like it, and we're going to repeal this,” he told ABC News.

President Barack Obama is expected to sign the bill as early as Tuesday, after which it will go to the Senate where Democrats hope it will be passed by a simple majority under budget reconciliation.

'New day in America'
The BBC's Adam Brookes in Washington says Mr Obama's long, stubborn effort to reform healthcare came to fruition after a dramatic late night in Congress. We have failed to listen to America… This body moves forward against their will. Shame on us

Rep John Boehner
House Republican leader
Full text: Obama hails result
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The House approved the bill passed by the Senate on Christmas Eve by 219 votes to 212, with 34 Democrats joining Republicans in voting against it.

Victory was assured only hours before voting started, when the president agreed to a deal with conservative Democrats to reiterate in an executive order that money provided by the bill could not be used for abortions.

Democrats were jubilant after the vote, with House Majority Whip Representative James Clyburn describing it as “Civil Rights Act of the 21st Century”.

Rep Marcy Kaptur of Ohio said the bill heralded “a new day in America”, while Rep Doris Matsui of California said it would “improve the quality of life for millions of American families.”

President Barack Obama: 'It's a victory for the American people'

The president said that after nearly 100 years of debate and frustration, Americans finally had the assurance of universal health cover.

“We pushed back on the undue influence of special interests,” he said in a statement. “We didn't give in to mistrust or to cynicism or to fear. Instead, we proved that we are still a people capable of doing big things.”

“This legislation will not fix everything that ails our healthcare system, but it moves us decisively in the right direction,” he added.

Under the plans, health insurance will be extended to nearly all Americans, new taxes will be imposed on the wealthy, and restrictive insurance practices such as refusing to cover people with pre-existing medical conditions will be outlawed.