The US Senate has approved President Barack Obama's healthcare overhaul, backing sweeping changes in the medical insurance market and new coverage for tens of millions of uninsured Americans.
On a party-line 60-39 vote, Senate Democrats supported the most dramatic shifts in health policy in four decades.
Mr Obama said today's was a 'historic vote' which brought closer the prospect of enacting the most important piece of social policy since the 1930s.
The early-morning Christmas Eve vote followed months of political wrangling that consumed the US Congress and put a dent in Mr Obama's public approval ratings.
The vote clears the way for tough negotiations in January with the House of Representatives, which approved its own version on 7 November that features different approaches on taxes, abortion and a proposed new government-run insurance program.
Once House-Senate negotiators agree on a single bill, each chamber must approve it again before sending it to President Obama to sign into law.
Democrats hope to finish work before Mr Obama's State of the Union address in late January.
The Christmas Eve Senate session, the first since 1895, fulfilled a pledge by Senate Democratic leader Harry Reid to pass the bill before Christmas.
Republican opponents delayed the final vote to the last day possible under Senate rules, but agreed to an early-morning vote to let people head home.
Senators called out their votes from their desk in a formal roll-call.
Senator Reid, who had been working around the clock for four weeks, mistakenly voted ‘no’ when his name was first called before voting for the bill, prompting a roar of laughter in the chamber.
The overhaul, Obama's top legislative priority, would lead to the biggest changes in the $2.5 trillion US healthcare system since the 1965 creation of the government-run Medicare health program for the elderly and disabled.
The bill would extend health coverage to more than 30 million uninsured, covering 94% of all Americans, and halt industry practices such as refusing insurance to people with pre-existing medical conditions.
It also would require most Americans to have insurance, give subsidies to help some pay for coverage and create state-based exchanges where the uninsured can compare and shop for plans.
Major provisions such as the exchanges would not kick in until 2014 but many of the insurance reforms like barring companies from dropping coverage for the sick will begin in the first year.
Republican critics say the bill is an expensive and heavy-handed intrusion in the healthcare sector that will drive up costs, increase the budget deficit and reduce patients' choices.
