HARRISBURG -- Over Republican objections, state House Democrats voted yesterday to expand the state's adultBasic health insurance program to cover more than 130,000 low-income adults.

Currently, only 46,000 low-income people between the ages of 19 and 65 are insured through the program, and there are an additional 236,000 adults on a waiting list, said Brett Marcy, spokesman for House Democratic Leader Todd Eachus.

The vote, which came after two hours of heated debate, was 104-96. All the opponents were Republicans. One GOP legislator, former House Speaker Dennis O'Brien of Philadelphia, joined 103 Democrats in voting yes. Three members were absent.

House Bill 1, the insurance expansion measure, was sponsored by Mr. Eachus, D-Luzerne. Besides adding people, it would change the program to cover prescription medications, chronic disease management, preventative and wellness care and behavioral health care. These expansions would qualify the program for a 54 percent federal subsidy -- money that's necessary for the bill to go into effect.

The remaining funds for the program would be generated by a 2 percent tax on nonprofit health insurance companies; $362 million from a state fund that helps doctors pay malpractice premiums; and $50 million that would be generated by reducing the time for state government to take control over unclaimed property.

But with President Barack Obama seeking to overhaul the federal health care system, Republicans questioned the need for new state health care reform efforts. House Republican Whip Mike Turzai of Bradford Woods said the state shouldn't move forward with a costly plan -- which relies on federal approval for funding -- until the federal system has been changed.

"It's not fair and it's not realistic," Mr. Turzai said. "The Democrats want to take money from cash-strapped businesses and families to pay for an expansion of a government program."

Mr. Marcy said House Democrats have "tremendous confidence" in Mr. Obama, but added, "History has taught us that developing programs at a state level produce better results for us as a Commonwealth."

Erik Arneson, spokesman for Senate Majority Leader Dominic Pileggi, R-Delaware, said the Senate would review the bill, but he also had some questions. He contended it would be "irresponsible for Pennsylvania to take action without first understanding any new federal law that emerges from that process."

Mr. Arneson added: "House Bill 1 does not include a sustainable funding mechanism and could require a tax increase."