RALEIGH The state Senate gave final approval to a health care bill laden with politics Tuesday, even as Gov. Pat McCrory renewed his objections saying the measure could cost state taxpayers millions of dollars.

With the 32-17 vote, the legislation now goes to the House, where Republican leaders plan to take a slower approach than the Senate, which pushed it through just days after being introduced.

The bill is designed to block the implementation of major parts of the federal health care law in North Carolina, preventing more low-income residents from receiving health coverage under Medicaid and prohibiting a state-sponsored online marketplace for insurance policies.

The GOP-dominated Senate used the debate to attack President Barack Obama’s health care law and demonstrated its independence from the governor. McCrory had asked the Senate to delay the bill.

House lawmakers plan to take a different tack, taking extra time to address the governor’s concerns, said Speaker Thom Tillis.

But the Cornelius Republican made it clear that the House, like the Senate, stands opposed to the federal health care law.

“I remain consistent in my opposition to both an expansion of Medicaid and the establishment of a state-based health exchange in North Carolina,” Tillis said in a statement.

McCrory is worried the bill may cost the state money because it would jeopardize a $40 million federal grant that pays for the current Medicaid tracking system. The state received the money after former Gov. Bev Perdue took the first steps toward a joint federal-state health care exchange.

“We are optimistic that we can hopefully work out an agreement with the House to deal with some of our concerns about the cost to the North Carolina taxpayers,” McCrory said Tuesday. “We hope we can work those out before it gets through the legislature.”

The expansion of Medicaid would provide health care coverage to as many as 648,000 low-income residents, a large portion of which don’t have health insurance. The program currently only covers low-income women, the disabled, the elderly and children. The federal government will fully fund the newly eligible for the first three years and then pay no less than 90 percent.

More than 700,000 North Carolinians are expected to shop for insurance policies through the online health care exchange. If the state doesn’t participate, the federal government will craft a marketplace for the state.

Elsewhere across the country, at least five Republican governors plan to take the money, while at least nine GOP chief executives are refusing to expand Medicaid.

Ohio Gov. John R. Kasich, a fierce opponent of the Affordable Care Act and a strident conservative, is the latest to opt for expansion. In releasing his budget this week, Kasich argued expanding Medicaid would save money because fewer uninsured people would seek care at emergency rooms and drive up health costs – the argument critics are making against the North Carolina bill.

Sen. Pete Brunstetter, a Winston-Salem Republican, said that if Washington changes the terms of the deal, lawmakers will reconsider. But right now, “we don’t trust the federal government” to pay for its share of the expansion. He said the Senate will alleviate McCrory’s concerns through separate legislation.