WASHINGTON - Calling it a "good start" but adding that she thinks Congress needs to be even more aggressive, Sen. Maria Cantwell supported a sweeping health care bill approved Tuesday by the Senate Finance Committee.

The Washington state senator was one of 13 Democrats joined by a lone Republican – Maine Sen. Olympia Snowe – who supported the $829 billion measure. Democratic leadership will now try to combine the Finance Committee bill with one passed earlier by the Senate Health, Education, Labor and Pensions Committee, and bring legislation to the floor in the coming weeks.

“Doing nothing was not an option,” Cantwell said as the Finance Committee debated the bill. “The big secret is premiums will continue to increase 7 percent to 8 percent unless we act. We need to decide whether we will let insurance companies continue to have their way or whether we will do something.”

Just before she spoke, the chairman of the committee, Sen. Max Baucus, D-Mont., led the members in singing “Happy Birthday” to Cantwell. She turned 51 on Tuesday.

Cantwell said the Finance bill would be good for Washington because it changed the Medicare reimbursement formula for doctors and hospitals. The current formula has shortchanged the state because it has had a more cost-effective, efficient health care system than most other states.

The bill also includes a Cantwell amendment that would allow other states to create basic health plans like Washington’s and use federal money to pay for them. The states would be allowed to negotiate coverage policies with insurance companies for low-income consumers, up to a family of four making $44,000 a year. President Barack Obama called Cantwell shortly after the amendment was adopted and thanked her for being “so constructive,” Cantwell said.

In an interview, Cantwell said more needs to be done, including the adoption of a government-run insurance plan, known as the public option.

“This is a start, but we need to do more,” Cantwell said.

The senator said 1 in 5 Washington state residents does not have health insurance, a figure that has grown 21 percent since the recession began. Insurance premiums in Washington state have more than doubled in the past 10 years, she said.

“We are trying to turn a really large ship,” Cantwell said, adding that earlier this year she thought the chances of Congress acting were 50-50. “Now, I would say it’s 60-40.”

The Finance Committee bill would require nearly everyone to have coverage, would bar insurance companies from using pre-existing conditions to deny coverage, and would provide subsidies to make insurance more affordable for low- and middle-income people. It does not include a public option.

The Health Committee’s bill does include a public option.

“I have voted for a bill with a strong public option because it’s the best way to hold down costs,” said Washington state’s senior senator, Democrat Patty Murray, who is a member of the Health Committee. “But I realize it will take 60 votes to pass the Senate.”