The House cleared the reconciliation package for the health reform bill a second time Thursday night, bringing months of legislative wrangling to an end and finalizing the largest expansion of government since Medicaid and Medicare.

Among other changes to the health reform bill, the package, which passed 220-207, grants seniors a $250 rebate to pay for prescription drugs if they fall into a gap of Medicare coverage know as the "doughnut hole," and reduces the fine from $750 to $695 for people who don't buy health insurance.

The package adds an additional $60 billion to the total cost of health reform, bringing the final fee to $940 billion over 10 years, according to estimates from the Congressional Budget Office. But the CBO believes the price will be substantially offset by increased taxes for those making more than $200,000 a year and higher fines for employers who fail to insure their workers, which will result in steeper cuts to the federal deficit.

The House cleared the package the first time along with the health reform bill on Sunday. While the health reform was signed into law on Tuesday by President Obama during a ceremony at the White House, the reconciliation package was sent to the Senate for final approval. There, Senate Republicans, on a legal technicality, struck down two minor points related to reforming education loans, which forced the package to go back to the House for its second vote.

The struck-out provisions dealt with the Pell Grant, and weren't immediately connected to the federal budget, as required by the parliamentary procedure used. However, the broader reforms to student loans, which now require the government to directly lend to student borrowers instead of guaranteeing loans given through private banks, remain in the passed package.

The Senate debated the reconciliation package for most of Wednesday night and Thursday morning, as Republicans tried to stall the passage by loading the bill with unpopular amendments. It eventually passed the bill 56-43 on Thursday, without the added amendments, which sent it back to the House for its second vote.

Despite days of tension and even violence - Senator Eric Cantor (R-Va.) reported someone had taken a shot at his office in Richmond, Va. - laughs were had when Senate Majority Leader Harry Reid (D-NV) mistakenly voted against the bill on Thursday, before switching his vote when the Senate passed the reconciliation package. Reid, who was one of the driving forces behind the bill, made the same mistake on Christmas Eve, when the Senate passed their original form of the legislation.

Although the legislative fight is over, the political, and legal, struggles will loom for months, if not years, to come. Fourteen attorneys general have already filed suit - in some cases, minutes after the bill passed on Tuesday - challenging the law's constitutionality.

And voter backlash could decide who controls Congress during elections this fall.

"The question is, will the passage of the health care overhaul also prove a Pyrrhic victory for Democrats - one that will devastate the winners in the 2010 elections?" asked Morton Kondracke today on the website CQ Politics.

A CNN poll taken this week found a substantial majority opposed the health reform bill, 59 percent versus 39 percent, although momentum appears to be swinging the other way. A more recent USA Today/Gallup poll, released on Tuesday, found a slim plurality in favor of the bill, 49 percent against 40 percent.

While the Congress was voting on the legislation, a victorious Obama during a speech at the University of Iowa dared GOP leaders to try to make good on any plans to stop the bill now. "Go for it," he said.