The Senate on Tuesday passed the largest overhaul of American Indian health care programs in more than a decade, a bill that would authorize new money and services for 1.8 million beneficiaries.

The measure, which passed 83-10, would reauthorize programs at the Indian Health Service through fiscal 2017 at $35 billion over 10 years. Spending for the programs in the current fiscal year is expected to total about $3 billion.

Just before passage, the Senate adopted by voice vote a substitute amendment by bill sponsor Byron L. Dorgan , D-N.D. The legislation now goes to the House, where a companion measure was approved by the House Natural Resources Committee on April 25, 2007, and by the House Energy and Commerce Health Subcommittee on Nov. 7. The full Energy and Commerce panel and the Ways and Means Committee have not yet acted on the legislation.

The Senate dispensed with several other amendments before passing the measure. By 52-42, it adopted an amendment offered by David Vitter , R-La., and sought by the White House that would bar funding authorized under the bill from being used to provide abortions, except in cases of rape or incest.

An amendment by Gordon H. Smith , R-Ore., to redistribute construction funds authorized under the bill was adopted 56-38. It would create a pool of money to distribute among all tribal organizations, instead of targeting construction funds to specific tribes. Smith has argued that some states, including Oregon, have never received construction funds for Indian health facilities.