AUGUSTA — The Maine House voted 79 to 68 today to approve an ambitious GOP health insurance reform measure and send it to the Senate, which is scheduled to take up the bill for the first time on Wednesday.

L.D. 1333 would overhaul the health insurance market for about 40,000 people – those who buy independently or through employers whose companies have 50 or fewer workers.

Still, it would affect almost every policyholder in the state because it would be funded by a tax on premiums of as much as $4 per person per month.

The bill would allow companies from every other New England state except Vermont to sell insurance in Maine. Current law prohibits out-of-state companies from selling insurance here. Vermont is excluded because it is moving toward a universal health care system.

The bill would give insurance companies more leeway in how much they can charge policyholders based on age and place of residence.

Critics say it would create winners and losers. While it would lower premiums for young people, by next year older people could be paying three times more for their policies than young adults. Current law limits the ratio to 1.5 to 1.

The bill would also prohibit insurers from rejecting people for pre-existing conditions. Those people could get the same insurance plans as everyone else.

In a preliminary vote last week, the House approved the bill in a party-line 76-72 to vote. In the vote today, Republicans increased their margin by picking up the vote of one Democrat, Rep. Stephen Hanley of Gardiner. Four lawmakers were absent.

The Senate adjourned today without taking action. Senate Majority Leader Jonathan Courtney, R-Sanford, said on Monday that the Senate would vote today. It’s unclear why the Senate did not begin debate on the bill.