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Democrats Sunday girded for the next battle to push the most sweeping US health care overhaul in a half-century through Congress, after handing President Barack Obama victory in a narrow House vote.
Following a razor-thin win late Saturday in the House of Representatives which saw 39 Democrats vote against the controversial bill, Obama urged the whole Senate to rally behind the issue when it takes up its version in the coming weeks.
"Given the heated and often misleading rhetoric surrounding this legislation, I know that this was with a courageous vote for many members of Congress," Obama said Sunday.
"Now it falls on the United States Senate to take the baton and bring this effort to the finish line on behalf of the American people. And I'm absolutely confident that they will."
After 12 hours of bitter debate, the bill squeaked through the House by 220 votes to 215 in a rare weekend session.
But amid the Democratic defections only one Republican broke ranks to back a 10-year, trillion-dollar plan to extend health coverage to some 36 million uninsured Americans.
Democrats now need all their 60 senators to come on board to have a hope of passing the legislation through the 100-seat Senate.
"The House bill is dead on arrival in the Senate. Just look at how it passed," said Republican Senator Lindsey Graham, signaling the tough fight ahead.
"You had 40 -- 39 Democrats vote against the bill. They come from red states, moderate Democrats from swing districts. They bailed out on this bill. It was a bill written by liberals for liberals," he told CBS television.
Senate Republican Leader Mitch McConnell noted that the bill passed very narrowly, noting that it "was rejected by one in seven House Democrats and a majority of Americans."
"It should serve as a stark reminder that Americans don't want a 2,000-page, trillion-dollar government experiment-they want common sense reforms," he said in a statement.
Democratic Senate Majority Leader Harry Reid signaled last week that intra-party divisions in the Senate mean the timetable could slip to 2010.
"We're not going to be bound by any timelines. We need to do the best job we can for the American people," said Reid, who needs 60 votes to ensure he can overcome parliamentary delaying tactics.
House Speaker Nancy Pelosi said the bill "improves quality, lowers cost, expands coverage to 36 million more people and retains choice."
But Republican Minority Leader John Boehner said it 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."
If, as expected, the House and Senate pass rival versions of health care legislation, they will need to thrash out a compromise bill and approve it before sending it to Obama to sign into law.
Obama and Democratic House leaders had invested much political capital in what they knew would be a close contest. The president telephoned wavering members on Friday and paid a rare visit to Congress on Saturday, but still 39 Democrats joined 176 Republicans to oppose the plan.
One Republican -- Anh "Joseph" Cao of Louisiana -- broke ranks, nominally fulfilling, in the barest terms, Obama's vow to secure bipartisan support.
The Vietnamese-American, who represents a heavily Democratic district, Sunday defended his vote as the right decision for his constituents.
"I made the vote to support the health care reform bill because a lot of my constituents are uninsured, a lot of them are poor and it was the right decision for the people of my district," Cao told CNN.
Final House passage came after a flurry of votes, including a 240-194 vote to sharply tighten restrictions on government funds for abortions, vital to bringing on board anti-abortion Democrats.
The United States is the only industrialized democracy that does not ensure that all of its citizens have health care coverage.
Under the White House-backed bill, all Americans would have to buy insurance and most employers would have to offer coverage to their workers -- though some small businesses would be exempt and the government would offer subsidies.
Washington spends vastly more on health care -- both per person and as a share of national income as measured by gross domestic product -- than other industrialized democracies, but with no meaningful edge in quality of care.
The bill would create a government-backed insurance plan, popularly known as a "public option," to compete with private firms and would stop companies denying coverage due to pre-existing medical problems.
