The House approved the bill 265-159. The Senate is expected to debate and vote on it soon.

President Bush says the bill's $60 billion price tag is double what is necessary. He has threatened to veto the measure and the House vote was short of a veto-proof majority, which is 290 if all members were present and voting.

But Democratic U.S. Reps. Neil Abercrombie and Mazie Hirono of Hawai'i and other supporters said the bill would dramatically reduce the number of uninsured children. They say states could cover 6 million children who are enrolled, plus an additional 4 million children.

"With this expansion of the program, we should be able to provide basic healthcare for every child who needs it," Abercrombie said. "Their health and well-being should never be determined by their parents' income."

Hirono said the program is cost-effective and called on Bush to sign the bill.

"It costs less than $3.50 a day to cover a child through the children's health insurance program," she said. "It would be far more expensive for taxpayers to leave these children uninsured and having to pick up the tab for indigent care in emergency rooms."

The bill would renew the State Children's Health Insurance Program until 2012 and add $35 billion for the program over five years by raising the federal tobacco tax.

S-CHIP, which Congress created in 1997, is a federal-state program designed to aid children from working families who make too much to qualify for Medicaid but not enough to afford private insurance. It helps states insure 6 million low- to middle-income children.

The program is set to expire Sunday.

Hawai'i currently has about 20,000 children enrolled in the program. The bill would allow coverage for another 12,000, Hirono said.

"I believe our nation must show true compassion for the most vulnerable among us," Hirono said. "This bill give states the resources and incentives necessary to reach millions of uninsured children who are currently eligible but not enrolled in the children's health insurance program."

Today's vote was the second time this year the House has voted on S-CHIP.

Earlier this year, House lawmakers approved a version of the bill that would have provided $50 billion for the program over five years, on top of the $5 billion a year the program now gets.

The bill approved today is essentially the same version the Senate approved Aug. 2. House lawmakers chose that course in response to Bush's continuing threats to veto any bill seeking an increase of more than $5 billion over five years.

Abercrombie, a member of the House Armed Services Committee, said the bill's cost is a fraction on what the Bush administration is spending to pursue the Iraq war.

"This administration is spending $300 million a day on the war in Iraq - more than $12 million an hour," he said. "I think our kids are worth at least a couple of hours of the war."