Vice President Joe Biden presided as 58 Democrats and two independents voted "yes" while Republicans unanimously voted "no."

Healthcare reform has been the top priority on President Barack Obama's domestic agenda. But finalizing the details of the legislation has been a lengthy and complex process.

After its passage, the bill will still have to be reconciled with a more expansive bill passed by the House of Representatives before being sent to Obama for signature, which will not happen until late next month.

"This morning is not the end of that process. It is merely the beginning. We will continue to build on this success, to improve our health system even more, and to further ease the terrible burdens on American families and businesses," said Senate Majority Leader Harry Reid, a Democrat from Nevada, upon the passage of the bill, known as the Patient Protection and Affordable Care Act.

"But that process cannot begin unless we start today. The American people and the American economy cannot afford for us to wait for next time, because there may not be a next time," said Reid.

He warned that Americans could not wait until the country becomes the only developed nation where you would die for lack of health insurance, pointing out the fact that roughly 45 million Americans were still without healthcare insurance as of this day.

Thursday's vote was a victory for Obama, who is going to make a victory note on the vote later in the morning, but it also reflected lingering divisions among Democrats and the fierce opposition of Republicans.

Senate Republican Leader Mitch McConnell said: "The most obvious problem with the bill in front of us is that it doesn't do what it was supposed to do."

"This debate was supposed to produce a bill that reformed healthcare in America. Instead, we're left with party line votes in the middle of the night, a couple of sweetheart deals to get it over the finish line, and a public that's outraged," he said.

"This fight isn't over. My colleagues and I will work to stop this bill from becoming law," said McConnell.

The final vote came after more than three weeks of rancorous debate and a series of hard-fought procedural victories beginning with a late-night vote on Sunday and culminating with Thursday's roll call at 7:00 AM (1200 GMT).

The 10-year US$871 billion measure would expand Medicaid -- the federal-state health program for the poor -- and create new tax subsidies to help lower- and middle-income families comply with a mandate to purchase insurance.

The Congressional Budget Office estimated the legislation would reduce the budget deficit by US$132 billion over the next decade, through a combination of tax increases on the healthcare sector and spending cuts, which largely fall on Medicare payments to healthcare providers.

(Xinhua News Agency December 25, 2009)