The House overwhelmingly approved an expansion of government-sponsored health care to 4 million more children Wednesday, and President-elect Barack Obama urged the Senate to quickly follow suit.
The House voted 289-to-139 in favor of the bill. Forty Republicans crossed the aisle and voted with majority Democrats to help pass the legislation. Two Democrats voted against the measure.
The House and Senate approved an increase in spending for the program, known as the State Children's Heath Insurance Program (SCHIP), in the previous Congress only to have President Bush veto it twice. The House fell short in both of its override efforts.
Congressional Democrats are now determined to paint stark contrasts between Bush and Obama to push legislation thwarted by the outgoing president, an effort that crystallized Wednesday.
Democrats view the SCHIP as one of the touchstones of their legislative agenda.
"The American public has asked for change," said House Majority Leader Steny Hoyer, D-Md. "This is an important and dramatic statement that change has come."
The $33 billion bill provides health coverage to an additional 4.1 million children who live at or near the poverty line. Some 7 million children are already enrolled in the program. The government pays for the additional insurance by imposing a 61-cent-per-pack tax increase on cigarettes.
"This coverage is critical, it is fully paid for, and I hope that the Senate acts with the same sense of urgency so that it can be one of the first measures I sign into law when I am president," Obama said in a written statement.
House Speaker Nancy Pelosi, D-Calif., described the passage as a triumph. But many Republicans decried the plan as an exercise in big government.
Rep. Paul Ryan, R-Wis., claimed the bill would strip some children from private insurance plans and move them to the government rolls.
"The taxpayers are going to pick up the tab," he said.
Other Republicans like House Minority Leader John Boehner, R-Ohio, worried that the bill could cover the health expenses of some illegal immigrants. Boehner said while the bill states that no illegal immigrants are eligible for coverage, there is no way to verify that.
The Senate Finance Committee wrestles with a similar bill Thursday. The full Senate could debate the legislation next week.