After a landmark win in the U.S. House of Representatives, President Barack Obama’s push for health care reform faces a difficult path in the Senate amid divisions in his own Democratic Party on how to proceed.

On 220-215 vote, including support by one Republican and opposition from 39 Democrats, the House backed a bill late on Saturday that would expand coverage to nearly all Americans and bar insurance practices such as refusing to cover people with pre-existing conditions.

The battle now shifts to the Senate, where Democratic leader Harry Reid searches for an approach that can win the 60 votes he needs. Some moderate Democrats have rebelled at Reid’s plan to include a new government-run insurance program, known as the “public option,” in the bill.


“As a matter of conscience, I will not allow this bill to come to a final vote,” said Sen. Joe Lieberman, the Connecticut independent who Democrats count in their camp when they need a 60th vote to rebuke a Republican filibuster.

Republican Sen. Lindsey Graham declared the bill “dead on arrival.”

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