Passage of a health reform Bill in the House of Representatives came at a critical time for President Obama. Not only did it provide badly needed momentum for his drive to provide healthcare cover to most Americans — it also blunted growing criticism in recent weeks that he is a President who does not get things done.

There is still a long way to go before a final Bill reaches his desk — there is a significant chance that the effort might still founder in the Senate — but yesterday was a key moment in US history, and for Mr Obama.

He has already achieved what no other US President has done: the passage of a sweeping health reform Bill in a chamber of Congress, eclipsing Bill Clinton’s disastrous effort which fell apart on Capitol Hill in 1994.

It also comes after a difficult few months, including votes in gubernatorial races in Virginia and New Jersey last week that showed independent and moderate voters deserting the President. Polls now show that he can no longer blame George W. Bush for the ailing economy.

The unemployment rate, which passed 10 per cent last week, is his problem. Pollsters have also noted a growing sentiment with voters: a concern that Mr Obama’s grandiloquence is not matched by achievement. After just nine months in office, the President is facing a growing impatience to show results.

The fact that Saturday night’s Bill passed the House by just five votes — where Democrats hold a big majority — demonstrated how difficult winning passage in the Senate will be, and how this victory could quickly fade.

Yet the White House is increasingly confident a Bill will eventually pass. If that happens, Mr Obama will sign one of the most seminal pieces of legislation in US history.

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