The bill, passed late Tuesday night in advance of planned labor protests, would let local officials unilaterally set health insurance co-payments and deductibles for their employees after a monthlong discussion period with unions. Leaders of the House said it would save cities and towns $100 million in the budget year that starts in July.

While Republican-controlled legislatures in Wisconsin and Ohio this year have weakened the ability of public-sector unions to bargain collectively, and Republicans in other states have pushed for a variety of curbs on unions, Massachusetts is the first state where a Democratic-led chamber has voted to limit bargaining rights.

“Everybody’s pretty upset,” said Robert J. Haynes, president of the Massachusetts A.F.L.-C.I.O. “It’s hard for me to understand how my good friends in the Massachusetts House, that have told me they support collective bargaining, could do this.”

But the bill faces uncertain prospects in the Senate, which is also controlled by Democrats. Senate President Therese Murray said Wednesday that she was pleased the House had “moved the needle” on the contentious issue of health care costs, but she has not endorsed the plan.

Dave Falcone, a Senate spokesman, said Friday that Ms. Murray “has been consistent in her message that something has to be done, that there has to be savings, and that everyone should have a seat at the table.”

While Gov. Deval Patrick, a Democrat, has not pledged to sign the bill if it reaches his desk, he proposed a similar plan early this year and praised the House this week for its “important” vote. He also raised concerns about a provision of the House plan allowing towns and cities to opt out of it and said unions must not have veto power over municipal health plans.

On Friday, Mr. Patrick said through a spokesman that labor must have “a meaningful role” in determining how to control health care costs, though he did not elaborate.

The House voted 111-42 in favor of the plan, with 81 Democrats approving it.

Representative Brian Dempsey, the Democratic chairman of the House Ways and Means Committee, said he supported it — and in fact helped create it — after seeing no other way of avoiding disastrous cuts to local public safety and education budgets. The legislature had urged municipalities and their unions to curb rising health costs for several years, he said, but with no success.

“We have to get a handle on this,” he said. “The fact of the matter is costs are going up and the money is not going to the areas we desperately need it to.”

He acknowledged, though, that it was “certainly difficult” to hear labor’s angry response.

Michael J. Widmer, president of the Massachusetts Taxpayers Foundation, a nonpartisan watchdog group that supported the plan, said the health care costs for cities and towns had been growing by about 11 percent a year and “cannibalizing” local budgets.

“Yes, it’s a small curtailment of their collective bargaining powers,” Mr. Widmer said of municipal unions, “but with the corollary that it will save lots of their members’ jobs.”

Under the House plan, co-payments and deductibles for municipal workers would have to be at least equal to those of state employees. And unions would retain the right to negotiate what portion of premiums their members paid.

Mr. Patrick and House leaders have sought to head off comparisons with the legislation that Gov. Scott Walker of Wisconsin signed earlier this year, saying the Massachusetts plan does not go nearly as far. That did not stop the Republican Party of Wisconsin from proclaiming Mr. Patrick “an ally” on Friday and congratulating him on the bill. Mr. Patrick is to speak at a Democratic Party dinner in Wisconsin on Saturday.

“It’s refreshing to see that even a liberal Democrat from Massachusetts recognizes the importance of collective bargaining reform,” Mark Jefferson, the Wisconsin Republican Party’s executive director, said in a statement.

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