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Mr. Obama signed the measure, the Patient Protection and Affordable Care Act, during a festive and at times raucous ceremony in the East Room of the White House. He spoke to an audience of nearly 300, including more than 200 Democratic lawmakers who rode a yearlong legislative roller coaster that ended with House passage of the bill Sunday night. They interrupted him repeatedly with cheers, applause and standing ovations. 本科

“The bill I’m signing will set in motion reforms that generations of Americans have fought for and marched for and hungered to see,” Mr. Obama said, adding, “Today we are affirming that essential truth, a truth every generation is called to rediscover for itself, that we are not a nation that scales back its aspirations.”

Moments later, the president sat down at a table and affixed his left-handed, curlicue signature, almost letter by letter, to the measure using 22 pens, most of which he intended to pass out as mementos to lawmakers, aides and a handful of others, including Victoria Reggie Kennedy, the widow of Senator Edward M. Kennedy, who had made passing the legislation his life’s work.

Mrs. Kennedy arrived wearing a blue bracelet that said “Tedstrong” on her wrist; Mr. Obama wore one, too. The senator’s son Representative Patrick J. Kennedy of Rhode Island, was also on hand, carrying a gift for the president: a copy of a bill his father introduced in 1970 to provide national health insurance. On it, the younger Mr. Kennedy had written a personal message to Mr. Obama.

Mr. Obama was joined as well by a select group of ordinary Americans, among them 11-year-old Marcelas Owens of Seattle, who became an advocate for health reform after his mother died without insurance, and Connie Anderson, whose sister is Natoma Canfield, the Ohio cancer patient whose struggles to pay rising health premiums became a case in point for Mr. Obama.

While Democrats exulted, Republicans, who describe the measure as an example of big government run amok, said it was no day to celebrate.

“This is a somber day for the American people,” said Representative John A. Boehner, the House Republican leader. “By signing this bill, President Obama is abandoning our founding principle that government governs best when it governs closest to the people.”

Despite the president’s signature, the legislative work on the bill is not over, nor is the partisan tussle over it. Republicans on Tuesday renewed their vow to repeal the measure, albeit with a fresh slogan, “repeal and replace,” in a nod to the political difficulties of campaigning to overturn a measure that includes popular new benefits, like allowing young people to stay on their parents’ plans until age 26.

Attorneys general in more than a dozen states, most Republican, filed lawsuits contending that the measure is unconstitutional. In the Capitol, the Senate opened what is expected to be a contentious debate on a measure that contains the final revisions to the health bill. Democrats and Republicans are bracing for a fierce fight that is expected to last the balance of the week. The Republicans have said they will try to block the measure, or at least use procedural weapons to punch as many holes in it as possible by striking out key provisions.

Democrats urged Republicans to stand down, given that the measure is already law.

“Now it is a fact,” declared Senator Max Baucus, Democrat of Montana. “Now it is law. Now it is history. Indeed, it’s historic.”

Tuesday’s signing ceremony was the beginning of what will be an intense sales pitch by the White House and leading Democrats to convince Americans of the benefits of the health bill. As soon as it was over, Mr. Obama went into campaign mode, traveling to the Interior Department — the federal building with the biggest auditorium the White House could find — to address a crowd of more than 500 cheering doctors, nurses, patients and federal employees.

It was a remarkable turnabout from just two months ago, when many Democrats thought the bill was dead after Scott Brown, a Massachusetts Republican, won Mr. Kennedy’s old Senate seat. His victory deprived Mr. Obama of his 60-vote supermajority and left Democrats deeply nervous. At the White House on Tuesday, they seemed jubilant, even giddy.

They chanted “Nancy! Nancy! Nancy!” as the House speaker, Nancy Pelosi, who had kept her skittish caucus together, entered the East Room. They posed for pictures in front of the president’s podium as they waited for Mr. Obama to arrive. When he did, accompanied by Vice President Joseph R. Biden Jr., the audience broke into his standard call-and-response campaign chant: “Fired Up! Ready to go!”

Mr. Biden introduced Mr. Obama, lauding the president’s “perseverance” and “clarity of purpose.” But in a remark that he clearly did not intend to be heard, Mr. Biden used a vulgarity in his private congratulations to the president that, while not audible inside the room, was picked up by a broadcast microphone and spread quickly across the Internet.

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