HARRISBURG - A bill aimed at providing health coverage to about 270,000 uninsured Pennsylvanians passed the state House of Representatives yesterday but faces long odds in the Senate.

The 118-81 vote would establish the Pennsylvania Access to Basic Care program, covering legal U.S. residents ages 19 to 64 who meet income guidelines and who have gone six months without insurance.

The bill (SB 1137) sponsored by House Democrats also provides help for smaller low-wage employers to offer workers health insurance.

"It's time to stop kicking the can down the road," said Rep. Karen Beyer of Lehigh County, who was among the Republicans who crossed party lines to vote for the measure. "We know that the lack of health care, those folks who are uninsured in the state of Pennsylvania, are an incredible drain on our economy."

Republican opponents called it an unnecessary and even counterproductive government program that was pushed through with inadequate input from hospitals, doctors and other interested parties.

The cost of the program, expected to reach $1.1 billion by 2012-13, also was targeted by critics. It would be funded with a combination of premiums, federal Medicaid dollars, tobacco settlement money and by dipping into the medical malpractice insurance fund.

"This legislation requires us to increase spending significantly over the next few years," said Minority Leader Sam Smith (R., Jefferson). "It is in fact . . . a tax increase waiting to happen."

Majority Leader Bill DeWeese (D., Greene) said a similar proposal favored by Gov. Rendell was the subject this year of extensive hearings that provided the public comment that Republicans were calling for. DeWeese criticized GOP lawmakers for inaction on health care during the recent 12-year span in which they controlled both legislative chambers.

"This is a very good start," he said. "Is it perfect? Of course not. But it takes it to the Pennsylvania Senate."

Pennsylvania ABC, as the program would be known, would expand the health insurance now offered under the more limited adultBasic insurance program to include prescriptions, behavioral health, prevention and wellness, and chronic disease management.

Rendell has expressed general support for the House plan, but Republican leaders in the GOP-controlled state Senate said its size concerns them.

"This General Assembly cannot, in good conscience, consider this type of extensive and highly complicated proposal without having all of the details in place - especially the funding," Sen. Don White (R., Indiana), chairman of the Banking and Insurance Committee, said after the House vote. "How can we support a program based on money we simply don't have?"

For Pennsylvania House roll call votes, go to http://go.philly.com/pahousevote