The number of Utah children without medical insurance could be reduced by more than a third if the U.S. Senate follows suit with the House, which voted Wednesday to expand a government-sponsored health-care plan for children.

The House voted 289-139 to expand the state Children's Health Insurance Program (CHIP) through 2013 and pay for it with $32.3 billion in expected revenue generated by upping the federal tax on a pack of cigarettes 61 cents.

About 4 million more children nationwide, including about 37,000 in Utah, could be added to the CHIP plan, which currently covers about 7 million children of working families who don't have coverage benefits at work and who earn too much to be eligible for Medicaid.

The reauthorization, which could come before the Senate as early as next week, has long been a priority of Democrats. Congress approved expanding it twice in 2007. Both times President George W. Bush vetoed it, although CHIP was temporarily reauthorized through this March by Congress.

Among the Utah House representatives, the lone supporter was Democrat Jim Matheson.

Matheson said, "This is going to make a difference for 4 million kids in this country, including a number of kids in Utah, who don't have access to health care" among the working poor.

Opponents in the House said Wednesday that the tobacco tax increase would not be enough to keep pace with the growing costs of health care. As a result, lawmakers down the road would have to cut children from the program or increase taxes.

Rep. Rob Bishop, R-Utah, and newly elected Republican Jason Chaffetz were two of those opponents.

"It requires Utah taxpayers to fund coverage for adults in other states. Second, it doesn't target help to poor kids first, but instead to wealthier kids. Third, the funding mechanism relies on the false assumption that we're somehow going to have 20 million new smokers to pay for this thing," he said.

The House passage is regarded by Utah's leading local children's advocate group as an important and real first step in retooling the economy and reforming the health-care system to include all Americans, 45 million of whom have no insurance coverage whatsoever.

Karen Crompton, executive director of the policy research and advocacy group Voices for Utah Children, praised Congress for its leadership but cautioned that reauthorizing CHIP is only a temporary bridge to reducing the number of uninsured children.

"We cannot allow it to turn into a 'bridge to nowhere,"' she added, hoping that the CHIP reauthorization is only an initial step in providing health care for all children.