WASHINGTON - (AP) - Summoned to success by President Barack Obama,the Democratic-controlled Congress approved historic legislationSunday night extending health care to tens of millions of uninsuredAmericans and cracking down on insurance company abuses, aclimactic chapter in the century-long quest for near universalcoverage.

"This is what change looks like," Obama said a few momentslater in televised remarks that stirred memories of his 2008campaign promise of "change we can believe in."

Widely viewed as dead two months ago, the Senate-passed billcleared the House on a 219-212 vote. Republicans were unanimous inopposition, joined by 34 dissident Democrats.

A second, smaller measure - making changes in the first -cleared the House shortly before midnight and was sent to theSenate, where Democratic leaders said they had the votes necessaryto pass it quickly. The vote was 220-211.

Far beyond the political ramifications - a concern the presidentrepeatedly insisted he paid no mind - were the sweeping changes thebill held in store for nearly every American, insured or not, aswell as the insurance industry and health care providers that faceeither smaller than anticipated payments from Medicare or highertaxes.

The nonpartisan Congressional Budget Office said the legislationawaiting the president's approval would extend coverage to 32million Americans who lack it, ban insurers from denying coverageon the basis of pre-existing medical conditions and cut deficits byan estimated $138 billion over a decade. If realized, the expansionof coverage would include 95 percent of all eligible individualsunder age 65.

For the first time, most Americans would be required to purchaseinsurance, and face penalties if they refused. Much of the money inthe bill would be devoted to subsidies to help families at incomesof up to $88,000 a year pay their premiums.

For the president, the events capped an 18-day stretch in whichhe traveled to four states and lobbied more than 60 waveringlawmakers in person or by phone to secure passage of his signaturedomestic issue. According to some who met with him, he warned thatthe bill's demise could cripple his still-young presidency, and hisaides hoped to use the victory on health care as a springboard tosuccess on bills to tackle stubbornly high unemployment thatthreatens Democratic prospects in the fall.

Obama watched the vote in the White House's Roosevelt Room withVice President Joe Biden and dozens of aides, exchanged high fiveswith Rahm Emanuel, his chief of staff, and then telephoned SpeakerNancy Pelosi with congratulations.

"We proved that we are still a people capable of doing bigthings," he said later in the White House East Room. "We provedthat this government - a government of the people and by the people- still works for the people.