After months of fierce debate in Washington and around the country and after an intense day of voting on Capitol Hill, the House of Representatives passed a health care reform bill and it's on its way to President Obama's desk.
Once Obama signs the bill into law, as he is expected to do on Tuesday, it will mean an end to the current health care system as we know it.
Pundits on the right and left have been reacting to passage of the legislation, but what does the bill actually mean for the average American?
The Huffington Post has compiled a list of the top 18 immediate effects of the health care bill as well as some that will take effect in the first year of implementation:
After more than a year of virulent debate, Democrats marched through a throng of jeering protesters, whose slurs recalled a Washington of the 1960s -- when the party forced civil rights legislation and Medicare through a fiercely divided Congress. Against unified Republican opposition, they built on that foundation Sunday with the passage of a health care reform bill that extends coverage to 32 million Americans and tightly regulates the insurance industry.
"It is with great humility and with great pride that we tonight will make history for our country and progress for the American people," said House Speaker Nancy Pelosi (D-Calif.) before the vote to a standing ovation on one side of the aisle and silence on the other. "Just think--we will be joining those who established Social Security, Medicare, and now tonight, health care for all Americans."
Democrats passed two pieces of legislation. The first, a comprehensive reform package passed at the end of December by the Senate, now goes to President Obama for his signature, passing the House 219-212. The second piece, passed through the reconciliation process by a 220-211, makes fixes to that measure and now heads to the Senate for a final vote.
Watch yesterday's health care debate condensed into 10 minutes:
The rancor of the protesters outside was audible inside the Capitol, where it resonated with the Republicans. In the afternoon, Republicans on the floor cheered when a protester in the visitors gallery was forcibly removed by police for interrupting proceedings by yelling "kill the bill!" Republicans fed the tea party crowd by appearing before them on a Capitol balcony with "kill the bill" signs, basking in the anger below them.
The hostility culminated in a tremendous breach of congressional rules when, as he spoke out against a GOP procedural ploy, Rep. Bart Stupak (D-Mich.), as pro-life as any Democrat, was called a "baby killer" by someone from the Republican side of the floor.
Republicans refused to identify the person responsible for the outburst, though Rep. John Campbell (R-Calif.) said he suspected it was someone from the Texas delegation sitting behind him. Some reporters suspected it was Campbell. The presiding officer, Rep. Dave Obey (D-Wisc.), told reporters he knew who it was but he declined to identify the person.
"Members have a right to make an idiot of themselves once without being exposed," he said.
It was a fitting end to vicious battle that will now be contested in the midterm elections, as Republicans vow to repeal the reform.
Rep. John Lewis (D-Ga.), a former Freedom Rider and Civil Rights leader who was the target of racial epithets on Saturday, asked by HuffPost about the slurs, said after the vote he felt "more than gratified."
"I feel a sense that we're on the side of the angels," he said. "When historians pick up their pen and write about this period, they will have to say that the majority party forgot about the politics and did the right thing."
Rep. George Miller (D-Calif.), chairman of the House Education and Labor Committee, said he was "honored" to have participated in the vote. "I can look people in the eye today and say, 'As of now, as this law is implemented, never again will you lose your health insurance.'"
The law will immediately clamp down on the insurance industry habit known as "rescission" -- dropping policyholders when they get sick -- but the major reforms will happen in 2014, when consumers will be able to choose an insurance policy among several available on an "exchange." There will be caps on out-of-pocket costs and subsidies depending on income. And insurance companies will no longer be able to deny coverage based on preexisting conditions.
The measure mandates all Americans hold health insurance and does not provide for a public option.
Some reforms will take effect almost immediately: Within 90 days of the president putting his signature on the bill, the Department of Health has to set up a $5 billion "interim high-risk pool" for people who are essentially uninsurable because they're sick. Within six months, insurance companies will not be able to deny coverage to children because of preexisting conditions.
"This isn't radical reform, but it is major reform," President Obama said in a statement after the vote. "This is what change looks like."