WASHINGTON (AP) — The U.S. Senate has passed President Barack Obama’s landmark health care overhaul in a climactic Christmas Eve vote, extending medical insurance to 30 million Americans.

The bill requires nearly all Americans to buy insurance and forbids insurance companies from denying coverage based on patients’ pre-existing conditions.

The 60-39 vote on a cold morning capped months of arduous negotiations and 24 days of floor debate. It followed a succession of failures by past Congresses to get to this point. Vice President Joe Biden presided as 58 Democrats and two independents voted “yes.” Republicans unanimously voted “no.”

The Senate’s bill must still be merged with legislation passed by the House before Obama could sign a final bill in the new year.

There are significant differences between the two measures but Democrats say they’ve come too far now to fail.

Vicki Kennedy, the widow of the late Massachusetts Sen. Edward Kennedy, who made health reform his life’s work, watched the vote from the gallery.

“This morning isn’t the end of the process, it’s merely the beginning. We’ll continue to build on this success to improve our health system even more,” Majority Leader Harry Reid said before the vote. “But that process cannot begin unless we start today … There may not be a next time.”

The House passed its own measure in November. The White House and Congress have now come further toward the goal of a comprehensive overhaul of the nation’s health care system than any of their predecessors.

Copyright 2009 The Associated Press.