Washington (CNN) -- The House of Representatives passed a sweeping health care bill Saturday night with a tight vote of 220-215, making it the biggest expansion of health care coverage since Medicare was created more than 40 years ago.The Affordable Health Care for America Act, or H.R. 3962, restricts insurance companies from denying coverage to anyone with a pre-existing condition or charging higher premiums based on gender or medical history. It also provides federal subsidies to those who cannot afford it and guarantees coverage for 96 percent of Americans, according to the nonpartisan Congressional Budget Office.
However, turning the bill into law remains uncertain.
The bill barely squeaked by in the Democrat-controlled House, with just one Republican voting for it -- first-time lawmaker Joseph Cao who holds a seat in predominantly Democratic New Orleans.
One hundred and seventy-six Republicans opposed it, as did 39 Democrats.
The Senate must now pass its own version of the health care legislation.
Senate lawmakers are also having a hard time winning over Republicans and conservative Democrats. It is unclear when the Senate will vote on its version.
Even if it passes, lawmakers in the House and Senate will have to reconcile their respective versions into one document and vote again.
President Obama said he was "absolutely confident" the Senate will follow suit in passing its version of the bill.
"I look forward to signing comprehensive health insurance reform into law by the end of the year," he said.
Video: House passes health care bill
Video: Health care bill passes
Video: 'What a night'
Key parts of the House health care bill
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With eight seconds left in the voting period, Democrats began counting down, erupting in roars when House.
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