The Senate gave final approval to revised legislation expanding the SCHIP children's health insurance program, again defying President Bush, who has said he will veto the measure for the second time.
The vote to send the legislation to Bush was 64-30. All six senators from the Philadelphia region voted in favor of the bill. A House vote Oct. 25 fell short of the two-thirds needed.
Democrats, who control Congress, have been unable to reach agreement with enough Republicans in the House to guarantee renewal of the State Children's Health Insurance Program.
Democrats want to substantially expand the 10-year-old program to enroll 10 million children, up from six million now.
Even as they prepared to vote, senators said talks on a compromise would continue.
"We are very close to a bipartisan, bicameral SCHIP bill," said Majority Leader Harry Reid, a Nevada Democrat, on the Senate floor shortly before the vote.
Bush, who vetoed a version of the measure Oct. 3, has said that by broadening SCHIP, Democrats were trying to undermine the U.S. system of private health coverage and replace it with government-run care.
This is a measure that speaks to what "we want to be known for," Sen. Benjamin L. Cardin (D., Md.) said during yesterday's debate.
A bipartisan group of senators who back the measure, including Charles E. Grassley (R., Iowa) and Max Baucus (D., Mont.), has been meeting with House Republicans on changes that could attract more of their votes.
Republicans want language to ensure that illegal immigrants can't qualify for benefits; steps to make sure poorer children are signed up before middle-income ones; and stricter limits on income eligibility.
The revised measure given Senate approval yesterday limits eligibility for government-subsidized insurance to children from families with incomes up to $62,000 a year for a family of four.
Originally, the legislation would have allowed states to apply for federal permission to set income eligibility at any level, with the U.S. payments reduced for families earning more than $62,000. States normally pay about 30 percent of the program's costs.
The legislation would add $35 billion over five years to the $25 billion program. The money would come from raising the U.S. tax on tobacco products to $1 a pack, from 39 cents.
SCHIP is a joint program of state and federal governments intended to cover children whose families earn too much to qualify for Medicaid, the U.S. program for the poor, and not enough to afford private insurance.