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The Democrats have won the first vote on health care, comfortably over the 216 they needed. It is on a procedural motion to continue with the general debate, but it is an indication of the way things are heading. They won by 224 to 206; 28 Democrats voted "no".

It was almost like the House of Commons with Jesse Jackson in the chair banging his gavel and calling the House of Representatives to order. Emotions have been running high at times, with Republicans warning of government tyranny, a European-style nanny state and an end to freedom. Equally emotional speeches from the other side talked about "healing America".

But the real work was going on behind the scenes to secure the last necessary votes. Negotiations had been going on for several days with Bart Stupak, who leads the anti-abortion Democrats. He won an executive order to be signed by President Obama once the vote has taken place.

The White House issued a statement saying:

While the legislation as written maintains current law, the executive order provides additional safeguards to ensure that the status quo is upheld and enforced, and that the health care legislation's restrictions against the public funding of abortions cannot be circumvented.

With that, Mr Stupak and his friends were in the bag. The president is due to speak as soon as the final vote is out of the way.

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