AUGUSTA, Maine — House lawmakers voted Tuesday to pass a sweeping and controversial health insurance overhaul bill that supporters say will lower rates through competition but critics warn could lead to costlier, less-accessible care for many Mainers.

The House voted 79-68 largely along party lines to approve the bill, sending it to the state Senate, where a lengthy and contentious debate is expected.

LD 1333 would allow Maine residents and businesses to purchase insurance from companies in other states and would allow small businesses to band together to purchase insurance. It also creates a high-risk pool subsidized by a $4-per-month fee charged to all policy holders.

But the bill would make other significant policy changes that Democrats predict could drive up insurance rates for older Mainers and those living in more rural areas or lead to fewer insurance options for those living in northern or Down East Maine.

For instance, the bill could allow insurance companies to charge higher premiums for older residents — up to five times higher than those charged for young, healthy individuals — and would eliminate limits on how far insurers can require policy holders to travel for care.

Republicans claim the changes will increase competition, draw more younger and healthier people into the insurance pool and lower costs. Democrats counter that Republicans have rushed through the legislation without allowing the Bureau of Insurance to do the actuarial studies that would determine likely impacts on the market.

House lawmakers held a lengthy debate on the issue last week. Only three legislators spoke on the floor about the bill on Tuesday, however.

House Minority Leader Rep. Emily Cain, D-Orono, cautioned that the bill could lead to higher premiums and fewer insurance choices for residents and businesses in rural Maine. Cain also said the way the bill was ramrodded through the GOP-controlled Insurance and Financial Services Committee and is being rushed through both chambers runs counter to the bipartisan spirit of this year’s legislative session.

“Maine people expect more,” Cain said.

Rep. Lance Harvell, R-Farmington, countered that the bill “seeks to set free a suffering youth” who cannot afford Maine’s high insurance rates.

Only one Democrat, Rep. Stephen Hanley of Gardiner, supported the bill. Four Democrats were absent.

The Senate could take up the issue on Wednesday, although the outcome is not expected to be different due to Republicans’ wider majority in that chamber. Republican Gov. Paul LePage supports the bill.

Maine’s health care overhaul comes at a time when states are preparing to implement the sweeping federal changes passed by Democrats in Congress and the Obama administration. Maine Attorney General William Schneider, a former Republican lawmaker, is party to a multi-state lawsuit contesting the federal health care law.

Rep. Sharon Treat, D-Hallowell, said many of the provisions in the bill passed by the Maine House on Tuesday would be pre-empted by the federal health care overhaul that’s taking effect in phases, but Republicans say the bill would work in tandem with the national law.

On Tuesday afternoon, the Insurance and Financial Services Committee scheduled a hearing on bills that also address key aspects of that federal law. Bills sponsored by Treat and Rep. Jonathan McKane, R-Newcastle, seek to create a health benefit exchange.

Exchanges, insurance marketplaces for individuals and smaller businesses designed to promote competition and drive down costs are required by 2014 under the national Affordable Care Act.

The Associated Press contributed to this report.