Joe Biden has hailed the US House of Representatives for passing a $1.75tn social and climate spending bill, a central pillar of his agenda that must now go before the Senate.

The Democratic majority in the House approved the Build Back Better Act on Friday despite fierce opposition from Republicans.

The bill represents “a giant step forward”, the president said in a statement. “Above all, it puts us on the path to build our economy back better than before by rebuilding the backbone of America: working people and the middle class.”

After months of fits and starts, gridlock and intra-party warring, Democrats leveraged their thin House majority to pass the most sweeping expansion of the social safety net since the 1960s.. The vote went almost wholly along party lines, 220 to 213, with Jared Golden of Maine the sole Democrat to oppose it.

Republican minority leader Kevin McCarthy had derailed the schedule to vote on Thursday by delivering a marathon overnight speech of eight hours 32 minutes. It was the longest speech ever made on the House floor but could only delay rather than deny the inevitable.

The House speaker, Nancy Pelosi, triumphantly brought down her gavel to mark the bill’s passage to enthusiastic applause throughout the chamber from Democratic members. There were chants of, “Build Back Better! Build Back Better!”

“The Build Back Better Act is passed,” Pelosi announced minutes later, smiling with arm aloft, to more cheering and chants of “Nancy! Nancy! Nancy!”

Soon after, a triumphant Pelosi said at a press conference: “We will be telling our children and grandchildren that we were here this day.”

The bill is “monumental, it’s historic, it’s transformative, it’s bigger than anything we’ve ever done,” she added.

On climate crisis action, Pelosi said: “If you care about the planet and how we pass it on, this bill is for you.”

The Build Back Better Act provides hundreds of billions to new social programs and action to mitigate the effects and worsening of the climate crisis.

Outside the US Capitol, progressive leader and Democratic congresswoman Pramila Jayapal said there was not agreement on every element of the bill but that she was pleased with the overwhelming support.

She called the bill “a very strong vote to send to the Senate”.

South Carolina congressman James Clyburn, who was instrumental in shepherding Black voters to support Joe Biden when he was struggling in the primaries during the 2020 campaign, eventually seeing him win the nomination and the White House, spoke of “a good day” as he appeared alongside Pelosi after Friday’s vote.

The bill now goes to the Senate, where it faces total opposition from Republicans and an uphill battle, in its current form, against centrist Democratic senators Joe Manchin of West Virginia and Kyrsten Sinema of Arizona.

The Senate majority leader, Chuck Schumer, has indicated that he wants the bill to pass the Senate, return to the House and be on the president’s desk by Christmas for signing, a tall order with more fierce debate yet to come and a crowded legislative calendar on Capitol Hill in December.

The huge bill will use the reconciliation process for budgetary-related legislation, meaning it can be passed in the Senate with a simple majority, rather than a 60-vote threshold, so that Democrats alone can see it through the chamber if they support it.

But in a hint of the wrangling to come, Bernie Sanders, an independent senator for Vermont, said: “The Senate has an opportunity to make this a truly historic piece of legislation. We will listen to the demands of the American people and strengthen the Build Back Better Act.”

The package is ambitious: it aims to dramatically reduce childcare costs, provide universal pre-kindergarten for children, lower the cost of prescription drugs for seniors, expand Medicare to cover hearing aids, extend work permits to millions of undocumented immigrants and provide the largest-ever investment in efforts to combat the climate crisis.

The House version of the legislation also includes four weeks of paid family and medical leave, though the provision faces opposition from Manchin.

Pelosi told reporters: “We had so much agreement within the bill … and then whatever comes out in the Senate, we’ll be working together with them so that we have agreement when it comes back to us. The biggest challenge was to meet the vision of President Biden.”

Five days ago Biden signed the bipartisan $1.2tn infrastructure bill into law at the White House, dealing with rebuilding America’s roads and bridges and spreading broadband internet.

The president is attending Walter Reed hospital for a routine medical check on Friday, the day before his 79th birthday.

His medical required a colonoscopy, which required going under anesthesia. As such, he briefly transferred power to the vice-president, Kamala Harris, the first time the US has had, albeit briefly, a woman as acting president.

Jen Psaki, the White House press secretary, tweeted that Biden had spoken to Harris at about 11.35am, adding:“@POTUS was in good spirits and at that time resumed his duties. He will remain at Walter Reed as he completes the rest of his routine physical.”