• The House of Representatives has passed the largest expansion of the social safety net in decades, a $1.75 trillion bill that funds many of President Joe Biden's top priorities.
• The bill is a major victory for House Speaker Nancy Pelosi, D-Calif., who pulled together a divided caucus to pass the mammoth bill with a thin majority.
• Now that it has cleared the House, the Build Back Better Act goes to the Senate, where it is likely to be revised in the coming weeks.

WASHINGTON — The House of Representatives on Friday passed the largest expansion of the social safety net in decades, a $1.75 trillion bill that funds universal pre-K, Medicare expansion, renewable energy credits, affordable housing, a year of expanded Child Tax Credits and major Obamacare subsidies.

The final vote was 220-213, and only one Democrat, Jared Golden of Maine, voted against the bill.

Now that it has cleared the House, President Joe Biden's Build Back Better Act goes to the Senate, where it is likely to be revised in the coming weeks. Senate Majority Leader Chuck Schumer said he aims to have the chamber pass the bill before Christmas. The House will need to vote on it again if the bill is altered.

If the measure is signed into law, the bill will profoundly change how many Americans live, especially families with children, the elderly and low-income Americans.

What's in the current version of the bill:

• Universal preschool for all 3- and 4-year-olds. In addition to helping millions of children prepare better for school, the benefit would enable parents of young children to return to the workforce earlier.
• A child-care cost cap of 7% of income for parents earning up to 250% of a state's median income.
• Four weeks of federal paid parental, sick or caregiver leave.
• A year of expanded Child Tax Credits. During the past year, these credits have raised households with more than 3 million children out of poverty and cut overall child poverty in America by 25%.
• Extended pandemic-era Affordable Care Act subsidies. So far this year, these subsidies have increased ACA enrollment by more than 2 million.
• New hearing benefits for Medicare beneficiaries, including coverage for a new hearing aid every five years.
• A $35-per-month limit on the cost of insulin under Medicare and a cap on out-of-pocket prescription drug costs at $2,000 per year.
• $500 billion to combat climate change, largely through clean energy tax credits. This represents the largest-ever federal investment in clean energy.
• An increase in the State and Local Tax deduction limit from $10,000 to $80,000.

The bill represents a major victory for House Speaker Nancy Pelosi, D-Calif., who pulled together a divided caucus with conflicting interests and united it behind a sprawling, 2,000-plus-page bill, passing it with a thin majority.

"This bill will speak for itself to millions and millions and millions and millions of Americans whose lives will be made more secure and richer in terms of their quality of life, whose educational opportunities will be greater, and whose job opportunities will be greatly enhanced," Majority Leader Steny Hoyer, D-Md., said Friday at a press conference after the vote.

The long road to a vote

Pelosi and Democratic leaders had initially hoped to pass this bill on Nov. 5, the same day the chamber voted to pass a $1 trillion bipartisan infrastructure bill.

But Democratic moderates insisted upon seeing a Congressional Budget Office analysis of the bill's impacts before they voted on it. That analysis was released Thursday. House Democrats had hoped for a vote Thursday night, but Republican leader Rep. Kevin McCarthy derailed those plans with a rambling, eight-hour-plus speech that lasted through the night and into early Friday morning.

Progressives were reluctant to throw their weight behind the infrastructure bill without an iron-clad assurance that moderates would in turn vote to pass the Build Back Better Act when it came to the floor later on.

They got that assurance, in the form of a statement from moderates saying in part that they would "commit to voting for the Build Back Better Act, in its current form" as soon as they got the CBO score.

But even after this compromise agreement was reached, six progressives still voted against the infrastructure bill, while 13 Republicans crossed the aisle to join Democrats in passing it.

Absent those 13 Republican votes, however, the bill would not have passed.

Last-minute compromise

The final language of the Build Back Better Act reflects a number of late-stage deals that Democratic leadership reached with small groups of holdouts.

Among them were Democrats who insisted on immigration language in the bill, a group of lawmakers from the Northeast opposed to the lower SALT deduction cap, and a third bloc of moderates who refused to support granting Medicare sweeping powers to negotiate prescription drug prices.

In each case, leaders and members reached a compromise, a testament to the trust that members of Pelosi's caucus still place in the speaker, even after months of sometimes tense negotiations.

For Golden, the only Democratic "no" vote, one of those compromises went too far: The large increase in the maximum that individuals can deduct on their federal tax returns for state and local taxes.

In a statement Thursday explaining his opposition, Golden noted that the long-term cost of lifting the SALT tax cap, around $280 billion over a decade, is greater than the "child care, pre-K, healthcare or senior care provisions in the bill."

Moreover, several analyses of the bill's outcomes have indicated that the majority of the savings to taxpayers in the SALT cap repeal provision will accrue to the benefit of high earners.

A major win for Biden

The Build Back Better Act and the separate bipartisan infrastructure bill together would represent the defining achievement of Biden's first year in office. The president signed the infrastructure bill into law earlier this week.

Together they fulfill his core campaign promise to be a president for the middle class, to tangibly improve the lives of working families and to address climate change.

More broadly, they serve as an example of Biden's argument around the world that "American democracy can deliver" a better quality of life than autocracies can.

The bills could hardly come at a more important time for the president. As inflation and a global supply chain crisis dominate many Americans' sentiments about the economy, Biden's approval ratings have plummeted.

Polls also showed that as Democrats in Congress battled over what would be in the bills, voters increasingly came to see the party as ineffective and wrapped up in "Washington problems," not in touch with the daily struggles of their constituents.

Next steps in the Senate

Now that it has cleared the House, the Build Back Better Act goes to the Senate, where it is likely to be revised in the coming weeks.

There, two conservative Democrats have an outsize influence on what happens next: Key swing vote Sens. Joe Manchin of West Virginia and Kyrsten Sinema of Arizona. Manchin has already said he opposes including paid leave in the bill.

Senate Budget Committee Chairman Bernie Sanders, I-Vt., has said he opposes raising the SALT cap deduction, arguing that it favors the wealthiest taxpayers and costs the government billions of dollars.