In a vote of 245-189, Republicans were victorious in passing a measure to repeal President Obama's signature health care overhaul law.
The final vote tally includes one no vote -- Rep. Gabrielle Giffords, D-Ariz., who continues her recovery. In addition, three Democrats voted with a solid Republican voting bloc to repeal the law -- Ross (AR), McIntyre (NC) and Boren (OK).
The repeal measure now moves to the Senate where is faces a steep uphill battle against a Democratic majority.
The Associated Press has a full re-cap of the day's debate:
WASHINGTON (AP) -- Eager to honor their campaign pledge, Republicans pushed legislation to repeal the nation's year-old health care law toward House passage Wednesday despite implacable opposition in the Senate and a veto threat from President Barack Obama.
Passage would clear the way for the second phase of the "repeal and replace" promise that victorious Republicans made to the voters last fall. GOP officials said that in the coming months, congressional committees will propose changes to the existing legislation, calling for elimination of a requirement for individuals to purchase coverage, for example, and recommending curbs on medical malpractice lawsuits.
Republicans also intend to try to reverse many of the changes Democrats made to Medicare Advantage, the private alternative to the traditional government-run health care program for seniors.
Like the repeal bill itself, these other measures will require Senate approval and a presidential signature to take effect, and the prospect is for months of maneuvering on the issue.
For many first-term Republican lawmakers, this day was one they had long waited for, a chance to speak and then vote on the House floor against a bill they had campaigned for months to repeal.
Rep. Jeff Duncan, R-S.C. said the legislation produced by Obama and congressional Democrats was a "job-killing, socialistic" approach to health care. Rep. Frank Guinta of New Hampshire, who defeated a Democratic incumbent last fall, said it was misguided, needing repeal.
"The American people have soundly, soundly rejected the Democrats' government takeover of health care," said Rep. Sandy Adams of Florida. Rep. Steve Southerland, also of Florida, said the law imposes a crushing tax burden on businesses, and he predicted "1.6 million jobs will be lost by 2014 due to this mandate" to require many businesses to provide coverage for employees. Both Floridians won their seats by turning out Democratic incumbents.
"This is not symbolic. This is why we were sent here," added Rep. Michelle Bachmann, of Minnesota, a third term conservative with strong support among tea party activists.
On the short end of the vote, Democrats challenged Republican claims and highlighted politically popular elements of the bill that would be wiped out if repeal took effect.
Rep. Jim Moran, D-Va., accused some Republicans of "the height of hypocrisy" by voting to repeal a vast expansion of health care at the same time they had signed up for coverage for their families through a government-organized program available to lawmakers.
Rep. Frank Pallone, D-N.J., said that despite claims of employment loss, the economy had added jobs in each of the past 10 months.
In one of the most animated speeches of two days of debate, Rep. George Miller, D-Calif., said repeal would return power to insurance companies. "Has anybody, any family in America, any single mother, any spouse, any child, any grandparent met a more bureaucratic system than the American health insurance system? There is no more bureaucratic system."
In the Senate, Majority Leader Harry Reid has said the legislation will not see the light of day there, although Republicans will seek ways to force a vote.
The law faces another challenge, well beyond the reach of Obama's veto pen. Several lawsuits have been filed, and while some judges have upheld the legislation, one recently ruled it was unconstitutional to require individuals to purchase insurance. The Supreme Court is widely expected to have the final word.
In the meantime, Republicans clearly relished the day.
The Obama administration has made a major effort in recent days to emphasize parts of the bill that have met with public approval, including one that permits children to age 26 to remain on their parents' policies if they do not have on-the-job coverage of their own. Democrats also argue that repeal would short-circuit other changes yet to take effect, including a ban on the insurance industry's practice of denying coverage or charging sharply higher premiums on the basis of a pre-existing medical condition.
Republicans intend to address the same issues with legislation they say they will bring to the House floor in the coming months, according to officials who have been involved in discussions on the issue, but no details were immediately available.
Last year, for example, the Republicans proposed a 10-year, $25 billion program to help states fund programs in which high-risk individuals could receive affordable coverage.
GOP leaders are working on the assumption that the repeal legislation will not become law, and they intend to draft future bills as changes to the structure that Obama and Democrats put into place.
On one point, they conceded no change was warranted. Majority Leader Eric Cantor, R-Va., told reporters on Tuesday seniors would be permitted to keep the $250 they have been promised to help defray the cost of drugs under the Medicare prescription benefit.
The legislation Obama signed last year was sweeping in its scope.
The Congressional Budget Office said at the time that when fully enacted, it would spread coverage to tens of millions who now lack it and - in a forecast rejected by Republicans - reduce federal deficits over the next decade.
Beginning in 2014, millions of Americans would be required to carry health insurance, whether through an employer, a government program, or their own purchase. New insurance marketplaces called exchanges would open in each state, enabling individuals and small businesses to pick from menus of private plans that met government standards. Federal subsidies would help defray the costs.