In both the House and Senate votes for the Affordable Care Act in 2009, no Republicans voted in support of the bill. Arlen Specter, originally a Republican senator from Pennsylvania, switched to the Democratic Party to support the bill, due to arguments over the contents.
The bill originated in the Senate, though both the House and Senate were working on versions of a health care bill at the same time. Democrats in the House of Representatives were not happy with the bill, as they had expected some ability to negotiate changes to the bill. Since Republicans in the Senate were threatening to filibuster any bill they did not support, and Democrats no longer had enough seats to override the filibuster, no changes could be made to the bill. Since any changes to the bill by the House would require it to be re-evaluated in the Senate, the original version was passed on condition that it would be amended by a subsequent bill.