House Democrats sensed the call of history late Saturday as they voted to provide health insurance to nearly every American in a milestone moment for their Caucus and President Barack Obama.

The legislative battle is far from over, with the Senate facing renewed filibuster threats Sunday from Sen. Joe Lieberman (ID-Conn.) and Republican Senators. But for the moment, ebullient House Democrats savored a victory decades in the making.

They let out a roar when Rep. Maxine Waters (D-Calif.) pushed the bill over the 218-vote threshold for passage, with hugs, tears, and relief following more than six months of tense negotiations and high drama that continued until the final moments.

The House kept running out of copies of the 2,000-plus-page bill because lawmakers wanted them as historic keepsakes, signing them for one another like high school yearbooks.

Rep. John Dingell (D-Mich.), the dean of the House and principal sponsor of the bill, presided over the debate on the rule, his first time in the chair since presiding over the 1965 Medicare debate. Dingell, who has been trying to pass universal health care since 1955, was mobbed by fellow Members seeking his autograph throughout the day.

And Speaker Nancy Pelosi (D-Calif.) was at the center of it all, whipping and re-whipping the final votes, personally corralling freshman Democrats like Reps. Tom Perriello (Va.) and Steve Driehaus (Ohio) and buttonholing old bulls like Rep. Marion Berry (Ark.) to make sure her vote count didn’t slip.

“For generations, the American people have called for affordable, quality health care for their families,— Pelosi said. “Today that call will be answered.—

In the final weeks, Pelosi showed once again her knack for tacking right to win passage, counting on her liberal base to swallow any compromises on behalf of the broader goal.

A week after Pelosi abandoned the “robust— public option tied to Medicare rates, which liberals had insisted was essential to get their votes, she caved in to the demands of abortion foes for a tough anti-abortion amendment on the House floor after negotiations fell apart late Friday. Pelosi’s concession infuriated many Democrats but proved key to passing the bill.

The final votes needed to secure passage weren’t locked down until Saturday afternoon, and even then, leaders nervously whipped against a feared Republican effort to attach a ban on illegal immigrants buying into the new national health insurance exchange.

Leaders were never assured that Hispanic lawmakers would not bolt on final passage if Republicans succeeded in adding tougher immigration language.

[IMGCAP(1)]When Republicans decided to use their one chance to amend the bill to float a crackdown on medical malpractice lawsuits, Hispanic Democrats celebrated, Democratic leaders began hugging one another and the celebration was on.

Despite the tight 220-215 margin on final passage, for leaders the vote lacked the nail-biting suspense of the June vote on climate change.

Pelosi cruised the floor, frequently beaming, assured of her victory.

By early afternoon, Democratic top brass had all but laminated their whip lists, with only Pennsylvania Reps. Christopher Carney and Jason Altmire remaining as question marks.

Altmire got the full treatment, bouncing from Pelosi to House Majority Leader Steny Hoyer (D-Md.), Appropriations Chairman David Obey (D-Wis.) and Appropriations Subcommittee on Defense Chairman John Murtha (D-Pa.) — and back. He still voted no.

Top aides said the results provided no big surprises — itself a surprise. Rep. Dennis Kucinich (D-Ohio), who had sent leaders mixed signals in the runup, proved the lone liberal protest vote against a bill some on the left felt had been watered down too much.

After Waters’ decisive vote, the capstone for the Democratic victory came when Rep. Anh “Joseph— Cao (La.) cast the sole Republican vote in favor of the legislation. With Minority Whip Eric Cantor (R-Va.) sitting by his side, Cao waited until Democrats showed they had 218 votes for the bill on their own before casting his vote, denying Cantor the unanimous opposition he had promised.

Rep. Loretta Sanchez (Calif.) was the last Democrat to vote, giving the bill its final margin.

Obama issued a statement late Saturday praising the House for passing the health care bill.

“Thanks to the hard work of the House, we are just two steps away from achieving health insurance reform in America,— Obama said. “Now the United States Senate must follow suit and pass its version of the legislation. I am absolutely confident it will, and I look forward to signing comprehensive health insurance reform into law by the end of the year.—

Democratic leaders had continued high-stakes negotiations late into Friday night to break a potentially ruinous deadlock over abortion language before spending Saturday putting the finishing touches on locking down a bare majority of support for the package.

Two social policy disputes — over abortion and immigration — that emerged in recent weeks as major hang-ups for the majority lingered into Saturday evening, providing a final burst of drama in a debate that never lacked for it. Anti-abortion Democrats won out against their pro-abortion-rights colleagues when Republicans joined them to approve a change tightly restricting access to the procedure under new health care programs. That the amendment got a vote at all was a major victory for the small clutch of anti-abortion Democrats.

Rep. Bart Stupak (D-Mich.), the architect of the anti-abortion push, said a compromise had been negotiated with Pelosi, but it fell apart Friday night after Pelosi said she could not get Pro-Choice Caucus Democrats to endorse it.

Stupak said the compromise would have included a permanent ban on the public insurance option providing abortion coverage. But the compromise included an abortion ban on private plans in the new national exchange that would have to be renewed annually, instead of the permanent ban lawmakers ended up endorsing.

The deal enraged abortion-rights supporters, who spent Saturday in a failed effort to find the votes to sink it.

“The Pro-Choice Caucus is furious and is going to do everything we can to defeat the Stupak amendment,— Rep. Diana DeGette (D-Colo.) said, adding that Pelosi herself was “furious, too.— DeGette blasted the amendment as probably the biggest limitation on a woman’s right to have an abortion that she has seen in her career. “This happened last night in the dead of night,— she said.

But those lawmakers ultimately lined up behind the bill on final passage, reasoning that the broader package was too important to oppose and that they could fight to strip the language in conference negotiations with the Senate.

Democratic leaders also struggled behind the scenes to deal with the immigration issue, with the White House and Senate Democrats backing a ban on illegal immigrants entering the national insurance exchange, while members of the Congressional Hispanic Caucus warned they could vote down the bill if the ban was included.

Rep. Luis Gutierrez (D-Ill.) blamed the White House for going too far in trying to refute Rep. Joe Wilson’s (R-S.C.) accusation that the president was lying about subsidies being provided to illegal immigrants.

“What the president did was he ginned this up to the point where he has a problem,— Gutierrez said.

The CHC also met with Obama earlier Saturday, with Obama hoping to secure their votes and Hispanic Members making clear their opposition to excluding illegal immigrants.

Despite passage of the bill, both abortion and immigration could potentially bedevil final passage of a conference report.

Rep. Jan Schakowsky (D-Ill.) was among Democrats who said they would vote down a conference report containing the Stupak language, while Gutierrez said he would vote against a conference report that contained the Senate ban on illegal immigrants in the exchange.

Democrats also had to beat back brushfires — including a last-minute objection from some lawmakers to a $24 billion tax provision banning “black liquor— generated by paper plants from qualifying for ethanol subsidies.

Setting the tone for leaders’ last pitch was an appeal from the closer-in-chief, Obama, who gave what attendees called a somber but inspirational call to arms for his cornerstone priority. In the midday address, delivered to a packed huddle in the Cannon Caucus Room, Obama exhorted Members to seize a historic opportunity by passing the bill.

Speaking off the cuff, the president opened by pointing to the killing spree at Fort Hood, Texas, earlier this week that left 13 dead and more than 30 wounded as an example of true sacrifice that puts in perspective the political heartburn the vote is causing some lawmakers. “I think it made a lot of people feel a little less sorry for themselves about their political problems,— Rep. Robert Andrews (D-N.J.) said afterward.

And the president congratulated Democrats for their successes this year while holding out the pending health care vote as the one that would stand as the proudest of their careers.

House Democrats hailed Obama’s appearance as a key rallying moment, but the day belonged to a giant closer to home. Dingell presided over the opening debate on the rule — and in one of the rare bipartisan moments of the day, he received a standing ovation from both sides of the aisle at the conclusion of that debate. Hours later, he closed debate on the bill itself.

Rep. Patrick Kennedy (D-R.I.) also brought up the legacy of his late father, Sen. Edward Kennedy (D-Mass.). His father may have been a Senator, “but his spirit was in the House tonight,— he said.

Republicans spent the day blasting what they termed a government takeover of health care, with a tea party protest outside the Capitol and plenty of vitriol inside it.

House Minority Leader John Boehner (R-Ohio) repeatedly complained that Democratic leaders refused to guarantee that abortion restrictions would stay in the bill through a conference with the Senate. And early in the day, Republicans objected to a series of Democratic women offering up garden-variety unanimous consent requests highlighting the bill’s benefits to women.

Republican Conference Chairman Mike Pence (Ind.) said the vote was historic, but in the wrong direction.

“If the Democrats keep ignoring the American people, their party is going to be history in about a year,— Pence said on “Fox News Sunday.—