President Barack Obama scored a major political victory with the US Congress passing a landmark bill to provide medical coverage to tens of millions of uninsured Americans, a feat that has eluded six presidents.

In the teeth of fierce opposition from a section of his own Democratic party, the House of Representatives Sunday approved a sweeping $875 billion healthcare measure, already approved by the Senate, by a narrow 219 to 212, after a day of often acrimonious debate.

As many as 34 Democrats joined the 212 Republicans voting en bloc against the bill. The bill now goes to Obama, who had made health care reform the top priority of his domestic agenda.

The House later also approved compromise changes to the Senate bill. The changes still need Senate approval.

However, Obama's signature on the main Senate health care bill would make the reform the law of the land, with or without the changes in the accompanying bill.

Democrats hailed the votes as historic, comparable to the establishment of Medicare and Social Security and a long overdue step forward in social justice.

Republicans contend the plan amounts to a government takeover of the private insurance system that will do little to slow spiralling medical costs.

'This is the civil rights act of the 21st century,' said James E. Clyburn, the No. 3 Democrat in the House. But Republican Paul D. Ryan denounced the bill as 'a fiscal Frankenstein' while colleague Virginia Foxx described it as 'one of the most offensive pieces of social engineering legislation in the history of the United States.'

A last-minute deal Sunday between Obama and House members who oppose abortion paved the way for Congress to pass the bill with Obama announcing he would issue an executive order to ensure that existing limits on federal funding of abortion remain in place under the health care reform bill.

Minutes later, Democrat Bart Stupak, and fellow anti-abortion colleagues said they would support the legislation.

The measure would constitute the biggest expansion of federal health care guarantees since the enactment of Medicare and Medicaid over four decades ago. It would extend insurance coverage to an additional 32 million Americans, according to a preliminary analysis from the Congressional budget office.