The health care portions of the bill would affect early every American and remake one-sixth of the national economy.
Beginning in 2014, most Americans would be required for the first time to purchase insurance, and face penalties if they refused. Millions of families with incomes up to $88,000 a year would receive government help to defray their costs. Large businesses would face fines if they did not offer good-quality coverage to their workers.
As Democrats trumpeted their bill, particularly its potential impact on the deficit, Republicans attacked it relentlessly as a government takeover of the health care industry financed by ever higher Medicare cuts and tax increases, including a new Medicare payroll tax on upper income wage earners.