TOPEKA, Kan.  — Republican lawmakers in Kansas failed to get a proposed anti-abortion amendment to the state constitution on the ballot Friday, and abortion opponents responded by moving aggressively to block a Medicaid expansion plan backed by Democrats and GOP moderates.

Neither side expected Friday’s vote in the Kansas House to be the last word on whether the abortion measure ultimately is put to a vote in a statewide election, when a simple majority would change the state constitution. It would overturn a Kansas Supreme Court decision last year that declared access to abortion a “fundamental” right under the state’s Bill of Rights.

Anti-abortion lawmakers struck back immediately with moves aimed at intensifying pressure on four Republicans who broke with the GOP on Friday’s vote and some Democrats in relatively conservative districts. They promised to hold up the bipartisan plan to expand the state’s Medicaid health coverage to as many as 150,000 additional people — a top priority for Gov. Laura Kelly.

Senate President Susan Wagle, a Wichita Republican, sent all 11 House-passed bills on the Senate’s debate calendar and another two Senate health care bills back to committee. She declared that no House-passed bill on any subject would clear committee until the abortion measure goes on the ballot.

But she drew a quick rebuke from Senate Majority Leader Jim Denning, a Kansas City-area Republican and the chamber’s No. 2 GOP leader, who worked with Kelly to draft the bipartisan Medicaid expansion plan. Denning said Wagle’s actions came “without my input” and did not reflect his plans.

“Her statements are obstructive and not how we should be governing,” Denning tweeted.

Kelly also said in a statement that Medicaid expansion “shouldn’t be derailed by political gamesmanship.”

Top Republicans vowed they would keep pushing for the proposed anti-abortion amendment’s passage. They said they’re not trying to ban abortion but trying to return to the status quo on abortion before the Kansas Supreme Court’s decision.

“It will come up — I can guarantee you that,” House Majority Leader Dan Hawkins, a Wichita Republican, told reporters after the vote. Lawmakers are scheduled to remain in session until early May.

The Senate approved the abortion measure last week, and the vote Friday in the House was 80-43. But supporters needed a two-thirds majority, or 84 votes in the 125-member House, for the proposed amendment to go on the ballot in the August primary election.

Supporters of the amendment justified their attack on Medicaid expansion by saying the Kansas Supreme Court’s decision protecting abortion rights, if not overturned, could lead the state’s courts to invalidate most or all of the restrictions enacted over more than 20 years.

They said that list contains a ban on abortions funded with state tax dollars, including under Medicaid.

Supporters held the House roll open for five hours so abortion opponents had time to work on reluctant lawmakers.

It was all to no avail: Not a single lawmaker switched their vote during the five-hour standoff.

Democrats argued afterward that the proposed amendment is simply too extreme. It would declare that the state constitution does not secure a right to abortion and give legislators the power to regulate it “to the extent permitted” by federal court decisions. Lawmakers could regulate abortion in cases of rape or incest or when a woman’s life is in danger.

Critics also said the proposed amendment would allow an outright abortion ban if the U.S. Supreme Court overturns its historic 1973 Roe v. Wade decision legalizing abortion across the nation.

“The Legislature would have absolute and total authority to pass any laws they see fit regarding abortion, so of course that could include a total ban,” said Rachel Sweet, a lobbyist for abortion provider Planned Parenthood Great Plains.

The timing of the statewide vote was an issue for the dissenting Republicans. They argued that the question should go on the November general election ballot, when the turnout is almost certain to be far higher, though some GOP moderates have acknowledged they’re worried the question would spike conservative turnout in the primary.

Supporters of the abortion measure said they chose the August primary so the question did not get lost amid the presidential election. But the smaller primary electorate also is more conservative, giving the amendment a better chance of passage.