The measure creates a dedicated funding stream for the Maryland Health Benefit Exchange, which is a new insurance market that will offer residents a choice of private health plans. While the exchange is on track to be up and running by Jan. 1 with federal help in the first year, the state will begin paying roughly $24 million in fiscal year 2015. The money will come from an existing 2 percent tax on insurance plans that are state-regulated.

The measure also includes an expansion of Medicaid eligibility to 133 percent of the federal poverty line, compared to the current 124 percent. The federal health care law gave states the option to accept expansion, refuse it or postpone a decision.

The bill was supported by 92 Democrats and one Republican; 42 Republicans and one Democrat voted against it.