Porter had voted against an earlier version of the bill in July. That vote triggered attacks from critics eyeing his seat for the 2008 election.

Porter said the new legislation was acceptable. He said it did not cut spending for Medicare, which would have harmed about 40,000 recipients in his district.

"This was a totally different bill," Porter said. "It is a victory for the children of Nevada and a victory for the seniors."

Porter added he would vote to override President Bush's threatened veto. The 265-159 vote, though, suggested the House does not have enough votes to turn back a veto.

Berkley said the bill would allow the expansion of Nevada Check Up, which provides coverage for 30,000 children in families earning up to roughly $41,000 a year.

The Congressional Budget Office estimated the new bill would fund coverage for an additional 34,300 Nevada children over the next five years.

Even at that, 78,700 children would remain uninsured in the state, according to census figures gathered by Families USA, an advocacy group.

"Nevada Check Up is already helping tens of thousands of families in the Silver State, but with more resources we can make sure that even more qualified kids have regular access to an array of vital health care and preventative services," Berkley said.

Heller said he was all for health care for children but he believed the bill is flawed.

He said costs would skyrocket as the program would cause families making three or four times the poverty level in some states to cancel private insurance in favor of government-subsidized coverage.

Additionally, the plan to pay for new coverage by increasing tobacco taxes would not raise enough money to support the expansion, he said.

"You will end up with more deficits," Heller said. "This is out-of-control spending, partisan politics of the worst that I have seen in the short time I have been here."

Heller said Democrats are "daring the president to veto a program that even the Democrats are dubbing the first step toward socialized medicine."

The bill now gets sent to the Senate, where Nevada senators also are split.

Sen. Harry Reid, D-Nev., supports the bill and is expected to vote for it.

Sen. John Ensign, R-Nev., said he will vote against it.

"The Democrats want to expand this program toward Washington-controlled government health care," Ensign said.