It was a close victory for President Obama, but a victory nonetheless.

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

He staked his young presidency on the outcome of this vote. House Speaker Nancy Pelosi made a final pitch for the bill, saying the president's economic agenda is at stake.

"The best action we can take on behalf of America's family budget and on behalf of the federal budget is to pass health care reform," she said.

In a country where most people rely on private insurance to help meet their medical costs, Democrats said the goal was to provide access to affordable coverage for as many Americans as possible.

Republicans stood united in opposition to the legislation, claiming it would increase the national debt, and put the government in firm control of the health care system.

As the debate came to a close, House Minority leader John Boehner issued a warning. "We have failed to listen to America," he said. "And, we have failed to reflect the will our our constituents.

The passions at play were evident both inside and outside the House chamber.

Protesters gathered on the Capitol lawn during the debate, yelling in an attempt to make their own voices heard.

There was anger from a woman from the state of Georgia. "There needs to be something done, but this is not it," she said.

And there was fear in the voice of a man from Missouri. "It needs to be reformed. It's broken," he said. "But spending us into oblivion is not the way to do it."

Supporters of the bill were there too. Jesse Jackson - a veteran of the civil rights movement - stood in the shadow of the Capital as a witness to history.

"To win this battle today is a major step toward changing our entire health care system," he said.

Nearby, there were a few people holding signs backing the bill. They were outnumbered by the opponents. But they could sense a legislative victory.

"It's a start," she said. "I'm just really excited. I had to be down here today."

It was a day for the history books...but not the end of the story. While the health care bill has cleared Congress, the Senate must still sign-off on a series of changes approved by the House. Senators are expected to act this week.

undue influence: 不正當影響

sign-off: 簽署同意

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Republicans wary of Obama's health care summit

What next for health care effort?

（來源：VOA 編輯：陳丹妮）