Senator Olympia Snowe approved 829 billion dollar bill on a 14-9 vote.
Snowe said she backed the plan with reservations and that she could not guarantee her continued support as the bill advances through Congress.
"My vote today is my vote today. It doesn"t forecast what my vote will be tomorrow," Snowe was quoted by news agency as saying.
All 13 Democrats on the committee supported the bill.
Republicans criticized the bill as too costly and said it was moving the country to more and more government control of health care.