The Vermont Senate voted 21-9 in favor of the health care overhaul bill advocated by Gov. Peter Shumlin.
The vote came after two full days of debate and follows approval by the House earlier this month.
Among Republicans who supported the initiative was Sen. Kevin Mullin of Rutland County.
Advocates of the legislation say it will help the state begin to drive down the cost of health care. It would authorize the state to participate in special health care exchanges established in the federal health care law enacted last year.
The Shumlin administration wants the bill to be the first step toward adopting a single payer system of paying for and administering health care. But the bill does not actually implement such a system.
A five-member Health Care Board would be established to oversee most aspects of the system.
There are some differences between the Senate bill and the version approved by the House. A conference committee will be appointed to develop a consensus, which will then be sent to the governor.