WASHINGTON -- A monumental overhaul of the nation's health insurance system passed the House tonight, in a vote that split Western Pennsylvania Democrats.

The final tally was a razor-thin 220-215 in favor of passage, a victory for House Speaker Nancy Pelosi -- who spent the past few days furiously drumming up votes -- and President Barack Obama, who made health care reform his chief domestic priority.

The focus now turns to the Senate, where debate on health care reform could last weeks or months.

The House bill would reform insurance practices, expand Medicaid and provide subsidies for those who cannot afford their own insurance -- resulting in insurance coverage for an estimated 96 percent of Americans. Those who do not have health coverage through their employer would enter the health insurance exchange, where customers would have their choice of plans -- including a government-run "public option."

The bill's opponents decried its length (about 2,000 pages), its cuts to Medicare (about $500 billion) and, in their minds, its potential to lead to government-run health care for all -- a claim Democrats vehemently denied.

Blue Dog Democrats Jason Altmire, of McCandless, and Kathy Dahlkemper, of Erie, voted no and yes, respectively, after refusing to reveal their intentions prior to the vote.

Both expressed concerns about abortion language, a debate settled with the passage of an amendment authored by Rep. Bart Stupak, D-Mich., that explicitly forbids people who receive government subsidies to purchase insurance plans that cover abortions. Also, the public option will not offer abortion coverage.

Among other members in the Western Pennsylvania delegation, Reps. Mike Doyle, D-Forest Hills, and John Murtha, D-Johnstown, voted for the bill. Reps. Tim Murphy, R-Upper St. Clair, Bill Shuster, R-Blair, and Glenn Thompson, R-Centre, voted no -- part of a united Republican front against the bill.

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