But the chances of this bill reaching Gov. Rendell's desk appear bleak.

While passage had been a priority of House Democrats, who symbolically numbered it House Bill 1, only a single Republican representative crossed party lines in the 104-96 vote.

It was sent to the Republican-majority state Senate, where a GOP spokesman said there were no plans to take it up, and a key committee chairman issued a statement sharply critical of the bill.

House Democrats called the bill a critical step to help victims of the economic downturn.

"The number-one cause of bankruptcy for working families in this country is the lack of health insurance," the sponsor, Majority Leader Todd Eachus (D., Luzerne), said after the vote.

"Many Pennsylvanians are one illness or one major injury away from losing everything," he said. "House Bill 1 will protect working families against the financial threat posed by the lack of health coverage."

The legislation would reduce the adultBasic program's two-year-long waiting list of about 236,000 and add new coverage for prescription drugs, chronic disease management, preventive care, and behavioral health. The adultBasic program currently serves 46,000 adults up to age 65.

The expansion would be funded by taxing nonprofit health insurers, tapping a fund that helps doctors pay malpractice premiums, reducing the reporting time for abandoned property, and getting federal funding.

But Republicans criticized the funding mechanism and said there were more effective alternatives that could attract votes from both sides of the partisan divide. Rep. Dennis O'Brien of Philadelphia was the only Republican yes vote.

Eachus' office said the bill would cost about $300 million the first year - roughly split between state and federal money - but Republicans argued there was no way to predict its cost over the long term.

Much of the floor debate centered on whether the state would be able to obtain permission from the federal government to use the tax on insurers as a dollar-for-dollar match for the program's cost.

Rep. Karen Beyer (R., Lehigh) sought to table the bill until federal officials could be brought in to clarify the issue. Her measure was voted down.

Sen. Don White (R., Indiana), chairman of the Banking and Insurance Committee, said the bill relied too heavily on one-time funding sources and was being advanced while Congress was debating its own health insurance expansion and the legislature was grappling with the 2009-10 state budget.

"Pennsylvania is staring at a revenue deficit of more than $3.2 billion and simply cannot afford to increase spending without a tangible and sustainable way to pay for it," White said.