Democrats in the House of Representatives got more than the 216 votes needed to pass the bill, which should expand medical coverage to more than 30 million Americans.
The legislation would also put the insurance industry under new regulations.
U.S. President Barack Obama, who has made health care reform a priority, is now expected to sign the bill into law.
Speaking after the vote, he said, "For most Americans, this debate has never been about abstractions, the fight between right and left, Republican and Democrat. "
"It's always been about something far more personal. It's about every American who knows the shock of opening an envelope to see that their premiums just shot up again when times are already tough enough," Obama said.
"It's about every parent who knows the desperation of trying to cover a child with a chronic illness only to be told no again and again and again. It's about every small business owner forced to choose between insuring employees and staying open for business."
Republicans have opposed the measure as too expensive and fear a greater role of government in health care.
It is the first major social reform in the United States since the 1965 Medicare bill for the elderly.
Health care reform has been a goal of U.S. presidents going back decades, but it has proved elusive, in part because self-reliance and suspicion of a strong central government remain strong in the United States.
compiled from agency reports
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