The passage of historic healthcare reform legislation in the US has not only extended insurance coverage to 32 million Americans but also given a much-needed shot in the arm to president Barack Obama.

After more than a year of political combat, Mr Obama says the legislation passed by the House of Representatives is “a victory for the American people” and “a victory for common sense”.

Healthcare reform has been a century-long quest, a goal sought by presidents both Democrat and Republican.

“Tonight’s vote is not a victory for any one party. It’s a victory for them. It’s a victory for the American people and it’s a victory for common sense,” Mr Obama said.

The president had staked his effectiveness and political legacy on the vote.

“This isn’t radical reform, but it is major reform. This legislation will not fix everything that ails our healthcare system but it moves us decisively in the right direction,” he said.

“This is what change looks like.”

The White House is now planning a public relations blitz from the president to turn around public opinion about the legislation, although officials say Mr Obama will not make healthcare reform a daily topic.

Just a couple of months ago, Mr Obama’s quest to overhaul America’s healthcare system seemed to have hit a dead end.

“Had health reform died, the take of the American people on government and on Obama and the Democrats, in particular, [would be] that they just can’t govern,” said Thomas Mann, a senior fellow at the Brookings Institution in Washington.

“The gang that couldn’t shoot straight would have miniaturised President Obama’s agenda, not prevented perhaps his re-election, but certainly put him in a position of being able to achieve little of what he wants.”

Despite the political triumph, Mr Obama expects the criticism to continue and he is already countering it.

“At a time when the pundits said it was no longer possible, we rose above the weight of our politics,” Mr Obama said.

“We pushed back on the undue influence of special interest. 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 and tackling our biggest challenges.”

Fight not over

Mr Mann says Republicans will not easily abandon their attempts to capitalise on the vote.

“Republicans are convinced that this victory will in fact be the undoing of the Democratic Party, but we’ll see,” he said.

“What’s important is this is a statement for the first time in our history that we, as a country, believe all the people here should be covered by health insurance.

“We are en route to figuring out a way to extend that coverage and to begin to get control of costs so that we, as a country, as a government and as individual citizens and companies, can afford it.

“That’s a huge step. We haven’t taken anything like that in decades.”

And that means Mr Obama has managed something that other presidents yearned for but none could achieve.

Bitter struggle

The road to healthcare reform has been long and rocky. For hours today, politicians slugged it out on the floor of the House.

“There are those who’ve told us to start over. There are those that have told us to wait. They have told us to be patient,” Democrat John Lewis said.

“We cannot wait. We cannot be patient. The American people need health care and they need it now.”

David Nunes summed up the Republicans’ views of the bill.

“For most of the 20th century, people fled the ghost of communist dictators and now you are bringing the ghosts back into this chamber,” he said.

“Today, Democrats in this House will finally lay the cornerstone of their socialist utopia on the backs of the American people.

“Say no to socialism. Say no to totalitarianism. Say no to this bill.”

Shame

The closing arguments were made by Democratic Speaker Nancy Pelosi and Republican leader John Boehner.

“We have come to this historic moment. Today we have the opportunity to complete the great unfinished business of our society,” Ms Pelosi said.

“Shame on this body. Shame on each and every one of you who substitutes your will and your desires above those of your fellow countrymen,” Mr Boehner said.

Every Republican voted against the legislation and they will use the unpopular law to batter Democrats in the lead-up to the November mid-term congressional elections.

Under the legislation, most Americans would be required to buy insurance and there will be subsidies to help them.

The insurance industry would be prevented from dropping people once they became sick or denying them coverage because of a pre-existing condition.