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The US House of Representatives has narrowly voted to pass a landmark healthcare reform bill at the heart of President Barack Obama's agenda.

The bill passed by 219 votes to 212, with no Republican backing, after hours of fierce argument and debate.

It extends coverage to 32 million more Americans, and marks the biggest change to the US healthcare system in decades.

"We proved that we are still a people capable of doing big things," Mr Obama said in remarks after the vote.

"We proved that this government - a government of the people and by the people - still works for the people," he added.

Mr Obama is expected to sign the legislation into law shortly.

The president has pulled off the most significant victory since his election 16 months ago, the BBC's Paul Adams reports from Washington.

Historic vote

Lawmakers held two votes into the late hours of Sunday - the first on procedural issues, and the second to pass the Senate-approved version of the health reform bill.

When the vote count hit the magic number of 216 - the minimum needed to pass the bill - Democrats hugged and cheered in celebration and chanted: "Yes we can."

Under the legislation, health insurance will be extended to nearly all Americans, imposes new taxes on the wealthy, and bars restrictive insurance practices such as refusing to cover people with pre-existing medical conditions.

The Republicans have vowed to continue resisting it.

They say the measures are unaffordable and represent a government takeover of the health industry.

"We have failed to listen to America," said Republican party leader John Boehner.

Speaking moments before the vote, House Speaker Nancy Pelosi said the health care reform honoured the nation's traditions.

"We will be joining those who established Social Security, Medicare and now, tonight, healthcare for all Americans," she said, referring to the government's pension program and health insurance for the elderly established nearly 50 years ago.

Although Democrats pushed the measure through with three votes to spare, 34 members joined Republicans in voting against the bill, worried about paying a political price in the November mid-term elections.

In a last-minute move designed to win the support of a bloc of anti-abortion lawmakers, Mr Obama earlier on Sunday announced plans to issue an executive order assuring that healthcare reform will not change the restrictions barring federal money for abortion.

Next steps

The House must now vote on a package of reconciliation "fixes" sought by some Democrats to the legislation.

If the House approves the package of changes to the Senate bill, the Senate would take it up next week using a procedure known as reconciliation.

That would allow budget provisions to be approved with 51 votes - rather than the 60 needed to overcome blocking tactics.

'Make history' Pelosi urges House

According to the Congressional Budget Office, the final version of the Democrats' healthcare plan will cut the federal deficit by $138bn (£92bn) over 10 years.

The non-partisan body said the proposed legislation would cost about $940bn (£626bn) over a decade.

The reforms will increase insurance coverage through tax credits for the middle class and expansion of the Medicaid programme for the poor.

They represent the biggest change in the US healthcare system since the creation in the 1960s of Medicare, the government-run scheme for Americans aged 65 or over.