Democrats needed 216 votes to pass the bill
The US House of Representatives has voted to pass a landmark healthcare reform bill that extends coverage to 32 million more Americans.
BBC News website readers sent their reaction to the result, describing how the health reforms will affect them.
ELSBETH TEAGUE, ASHEVILLE, NORTH CAROLINA
Elsbeth Teague says life without insurance would be 'hell'
This bill might only make a small difference for some people, but it could mean a massive difference for me.
I'm 21 years old and two months away from graduating college, at which point, I'll lose health insurance.
I suffer from bipolar disorder. I take prescription medication that I can't go off of.
My medication changed my life. It stabilises me. Without it, things are a little bit hellish.
If the bill doesn't become law, I don't know how I'm going to pay for it. To pay for private insurance would cost around $500 a month. I can't afford that.
This is great news for those of us who can neither afford healthcare nor can even qualify for it, i.e. pre-existing conditions. While it could've been a better bill, any change at this point is great news for all and I hope everyone realises it!
Conor, Chico, California
A sad day for America with the Federal Government taking over healthcare. I fully expect the availability and quality of healthcare to go down while the cost to our country will bankrupt us.
Tom Graves, Parker, CO
In the short term, I suspect this bill will actually hurt me financially. However, I am embarrassed that my country has taken this long to address a health care system that has been threatening our collective and individual economic futures. It would have been morally wrong to continue to do nothing while millions of families either live in fear of losing everything due to medical issues, or have already done so.
Liberal Atheist, Levittown, PA
This bill is joke. It will only hurt us more while making the insurance companies richer. We don't have any money for Medicare, we are spending billions on unjust "wars" and now the government wants to run our health "care" too.
Richard, Rome, NY
So many college students, including myself, have felt the blow a staggering hospital bill can inflict. This bill will do much to do rid us of that sinister spectre.
Cole Kirchner, Arcata, CA
This is something many Americans need. My parents are self employed. They both have pre-existing medical conditions. I also have a younger sister with heart problems. They can not receive health insurance at an affordable price do to their conditions. I worry about them all the time and what could we do if one of them needed procedures to save their lives.
Aaron P, Orange County, California
As the richest nation and the greatest democracy in the world, America must at the very least provide health care for all of its citizens. This legislation is historic and when President Obama signs it into law, the United States of America will truly be a nation of opportunities for all.
Joe Flomo Matthew, Cleveland, Ohio
It's a sad day. The Democrats did not follow parliamentary procedures because they knew that it would not pass if done properly. The bill was filled with promises not related to health care and political thugs forced their agenda.
Randall S. Sawyer, Malvern, Arkansas
As a rational thinking American, I don't believe for one second that bringing in 32 million people who can't afford health insurance will reduce any deficit. And, I don't want to pay higher taxes for four years before even one benefit is realised by anyone. This entire thing is just a power play by Obama who is using nothing more than thug tactics to threaten lawmakers into voting. Remember, ALL Americans have emergency care right now so no one can really say they have no health coverage.
Carl Smith, Carlsbad, Ca
Are you in the US? What is your reaction to the vote? How will the healthcare reforms affect you? Send us your comments.Please remember to include your phone number.
Send your video comments and pictures to firstname.lastname@example.org or text them to +44 7725 100 100. If you have a large file you can upload here.
Read the terms and conditions
In most cases a selection of your comments will be published, displaying your name and location unless you state otherwise in the box below.
The BBC may edit your comments and not all emails will be published. Your comments may be published on any BBC media worldwide.