Washington  - The debate over US health insurance reform inched forward another step Saturday when the Senate voted 60 to 39 to start debate on a bill that aims to extend coverage and reduce health costs.

It was perhaps the most important vote to date, yet just another step in US President Barack Obama's long struggle to enact far- reaching health insurance reform.

Senate Majority Leader Harry Reid led the centre-left Democrats' efforts to bring the bill out of committee and onto the floor for debate. He needed 60 votes to do so, the three-fifths majority necessary to bring things to discussion. (dpa)