OKLAHOMA CITY (AP) — The Oklahoma House rejected a proposed $1.50-per-pack tax on cigarettes to help stave off cuts to the state's health care system, with Democrats uniting against the plan until it includes an expansion of Medicaid for the working poor.

Even after more than two hours of efforts by Republicans to wrangle votes, the bill failed on a vote of 59-40 late Wednesday. The author indicated he may bring the bill back to the floor for reconsideration, but it cannot pass without some Democratic support.

Because the bill includes a tax increase, it requires 76 votes to pass the 101-member House and 36 in the 48-member Senate. Lawmakers are racing to close a $1.3 billion hole in the state budget that could result in deeper cuts to public schools, prisons and other state services in the fiscal year that begins July 1.

"The Democrat caucus en bloc is voting against this measure that is the key to keeping nursing homes open across our state, keeping hospitals open across the state," Republican House Speaker Jeff Hickman said.

The 30 House Democrats have said they won't support the tax until Republicans agree to some version of Medicaid expansion that would allow Oklahoma to tap into hundreds of millions of dollars available to states through the Affordable Care Act.

"Our entire position has been consistent since day one," said House Democratic leader Rep. Scott Inman. "If they want to do a cigarette tax, we'll do it with them if they choose to bring those federal dollars home. We haven't changed.

"It makes no sense to say we have to have a $180 million cigarette tax, but leave $900 million on the table. We can have both."

Under a Medicaid expansion, the federal government would agree to pay 100 percent of the cost of adding tens of thousands of working poor to the Medicaid rolls at first, but Oklahoma would be required to pay 5 percent beginning in 2017 and its share would gradually increase up to 10 percent by 2020.

Republican Gov. Mary Fallin has proposed accessing the enhanced Medicaid funding through a rebalancing plan that would expand eligibility to the working poor by shifting some current Medicaid-eligible pregnant women and children into the private insurance market. But a House bill to approve the "Medicaid Rebalancing Act of 2020" is hung up in the Senate, and Fallin said Wednesday that some of the blame for the stalemate lies with Senate Republicans, who have a 39-9 edge over Democrats.

"It's three separate bodies working together, a three-legged stool with the House, the Senate and the governor's office that negotiates the budget," Fallin said. "They have to pass things for me to sign it."

Sen. Greg Treat, the vice chairman of the powerful Senate Appropriations Committee, said he thinks a cigarette tax could have a chance in the Senate, but there isn't much support among Republicans for accessing enhanced Medicaid funding.

"I don't think there's a strong appetite to hear an expansion of Medicaid," said Treat, R-Oklahoma City. "Voters have spoken loud and clear. They don't want to accept Obamacare, and for us to do so would be counter to the wishes of the people in my district."

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