But victory was less certain in the Senate, and House Republicans lack the votes to override a threatened presidential veto. The labor of producing a compromise acceptable to both sides is expected to keep Congress in town until Thanksgiving or Christmas.
Advocates see it as an overdue effort to level the playing field for competition with insurers.
Insurers say it would give providers an unfair advantage. A last-minute amendment to the House bill gives the government sweeping new power to pursue health care fraud. It's the first measure to add health fraud to the criminal code and the first federal fraud ban that applies to all payers. Providers worry they could be put at risk of jail for common business practices. Patient-protection provisions in the House bill, although not perfect, are winning praise from physicians.