After a month of debate the US senate has passed a historic healthcare reform bill.
All 60 members of the Democratic caucus voted in favour; 39 Republicans were opposed.
The vote was overseen by the senate's president, US Vice-President Joe Biden.
Among the notable attendees was 92-year-old Robert Byrd of West Virginia, who had to be wheeled into the chamber to cast his vote.
"I'm doing it for my friend Ted Kennedy," he told his colleagues, referring to the long-time Massachusetts senator who had done so much for healthcare reform in this country but who died in August and whose spirit was very much felt around Capitol Hill on Thursday.
So much so that one of the first people President Barack Obama telephoned when the result came in was Victoria Kennedy, the late senator's wife.
It's taken almost a year of painfully slow and, at times acrimonious, debate - especially in the last 25 days - to get to this point.
Senate Majority Leader Harry Reid was clearly delighted at the 7am vote which makes healthcare affordable for 94% of Americans - an extra 34 million people - but not the undocumented.
"It's a victory for the American people," he said.
Now the hard work reconciling the $871bn senate bill with a $1tr House of Representatives version must begin.
Harry Reid's counterpart in the senate, Republican Minority Leader Mitch McConnell, pledged to go on fighting against the reform, saying they do nothing to bring down healthcare costs.
"My colleagues and I will work to stop this bill becoming law," he said.
Speaking before leaving for a family holiday in Hawaii - a departure he delayed to be in Washington for the vote - Obama said though there's a long way to go, Thursday's outcome in the senate is significant for American healthcare.
This legislation "brings us towards the end of nearly a century of struggle for healthcare reform", he said.
Congress is now closed 'til January 4th for the Christmas holidays, but when they return, Democratic leaders will begin the difficult task of bringing the two health bills together.
The outcome of Thursday's vote in the senate may have been virtually was guaranteed. But what happens next is not.
There are significant differences between the senate and House of Representatives versions of the bills - not least on how to pay for the reforms.
The two bills will need to be reconciled into one before the president can sign it into law.
Meanwhile, the congress is split between those on the left who think the reforms don't go far enough, and those on the right who think they are too expensive.
The White House hopes to be able to sign a new health-reform bill by the end of January. But it could take far longer if agreement can't be reached.
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