The 435 member US House of Representatives passed a health reform bill by a narrow margin of 220 to 215 votes late on Saturday 7 November.

The bill would provide health insurance for about 36 million of the 46 million currently uninsured Americans. It is predicted to cost $1100bn (£655bn; €735bn) over the next decade but also to reduce the national deficit by $104bn over the same period.

The Affordable Health Care for America Act will be funded by a tax surcharge on single US citizens who earn more than $500 000 a year and on families who earn more than $1m; by a penalty on people and companies who do not buy or provide health insurance; and by a reduction in Medicare payments to healthcare providers.

The bill was supported by the American Medical Association and AARP (formerly the American Association of Retired Persons), which represents people aged over 50, and many consumer groups, patients’ groups, and labour unions.

Thirty nine members of President Obama’s …