AUGUSTA — A proposal by two moderate Republican senators to expand Medicaid and incorporate drastic changes in the state Medicaid program has cleared the Legislature’s Health and Human Services Committee and will now be taken up by the full Senate.

The bill — crafted by Assistant Senate Minority Leader Roger Katz of Augusta and Sen. Tom Saviello of Wilton — would accept federal funding under the auspices of the Affordable Care Act to expand Medicaid, known here as MaineCare, to roughly 70,000 low-income Mainers, while also taking steps to implement managed care, a system to outsource the MaineCare program to private for- and nonprofit companies.

Katz and Saviello have put the bill forward as a compromise: Democrats get the Medicaid expansion they tried unsuccessfully to achieve last year, while Republicans get managed care and other cost-saving measures meant to control costs in MaineCare.

The committee vote was always expected to fall largely along partisan lines, but it came as a surprise to most that Rep. Carol McElwee, R-Caribou — one of the only House Republicans to support Medicaid expansion last year — switched her vote to oppose the measure.

That could be a bad omen for majority Democrats in the Legislature, who even with the support of two moderate Republicans still face an uphill battle to muster the Republican support necessary to override a certain veto by Republican Gov. Paul LePage.

After McElwee’s flip, the final Health and Human Services Committee vote stood at 7-5, with each Democrat supporting the bill and each Republican opposed. The bill will be sent to the Senate for an initial vote as soon as Tuesday.

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