After decades of failed attempts by a string of Democratic presidents and a year of bitter partisan combat, President Obama signed legislation on March 23, 2010, to overhaul the nation's health care system and guarantee access to medical insurance for tens of millions of Americans.
It was the largest single legislative achievement of his first two years in office, and the most controversial. Not a single Republican voted for the final version, and Republicans across the country campaigned on a promise to repeal the bill. After they took control of the House and expanded their ranks in the Senate in the November elections, action on health care was at the top of their agenda.
On Jan. 19, 2011, the House voted 245 to 189 in favor of repeal, in what both sides agreed was largely a symbolic act.
A few weeks later, Senate Democrats defeated a bid by Republicans to repeal the sweeping health care overhaul, as they successfully mounted a party-line defense. The vote was 47 to 51, with all Republicans voting unanimously for repeal but falling 13 votes short of the 60 needed to advance their proposal.
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