The US House approved the broadest overhaul of US health care in four decades.

12 hours of bitter debate finalized with a 220-215 vote in favor of the bill, which  amounts to a 10-year, trillion-dollar plan to extend health coverage to some 36 million Americans who lack it.

“Tonight, 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,” Obama said.

The fate of the bill now rests in the lap of the Senate  and 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.

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.

If, as expected, the House and Senate pass rival versions of health care legislation, they will need to work out a compromise version and approve it in order to send it to Obama to sign into law, a frequently tough process.