WASHINGTON (Reuters) - The Democratic-controlled U.S. House of Representatives rejected an alternate Republican health plan on Saturday and prepared for an expected close final vote on a bill that would lead to the biggest healthcare overhaul in four decades.
Democratic leaders said they were confident they could secure the 218 votes needed for victory on a sweeping overhaul of the $2.5 trillion (1.5 trillion pound) U.S. healthcare system backed by President Barack Obama, who has made it his top domestic priority.
The final vote was expected within an hour.
As expected, Democrats rejected on a 258-176 vote the much smaller Republican healthcare plan, which focussed on cost controls and curbing medical malpractice lawsuits but did not include many of the insurance changes of the Democratic plan.
The House also approved on a 240-194 vote an amendment that would impose tighter restrictions on using federal funds to pay for abortions.
House Democratic leaders agreed to allow the vote on the amendment to mollify moderate House Democrats who threatened to oppose the overhaul without changes to ensure federal subsidies in the bill for insurance purchases were not used on abortion.
The move enraged Democratic abortion rights supporters, but they were expected to vote in favour of the bill with the hope they can remove the language later in the legislative process.
The Democratic healthcare reform plan is designed to rein in costs, expand coverage to millions of uninsured and bar insurance practices such as denying coverage to people with pre-existing medical conditions.
If approved by the House, the battle over healthcare reform would move to the Senate, which has struggled to craft its own version. Differences in the House and Senate bills ultimately would have to be reconciled, and a final bill passed again by both chambers before it is sent to Obama for his signature.
House Republicans and Democrats battled in sometimes heated debate over the bill, which would lead to the biggest policy changes in the U.S. healthcare system since the creation of the Medicare government health program for the elderly in 1965.
"No longer can insurance companies come between you and your doctors," House Speaker Nancy Pelosi, a Democrat, said.
Republicans are united in opposition, criticizing the bill's $1 trillion price tag, new taxes on the wealthy and what they said was excessive government interference in the private health sector.
"We can't afford this bill," said Republican Representative Roy Blunt. "It's a 2,000-page road map to a government takeover of healthcare."
(Editing by Arshad Mohammed, Todd Eastham and Paul Simao)
