BOSTON — Lawmakers have again rebuffed Gov. Charlie Baker’s efforts to tie a $200 million health care assessment on Massachusetts employers to changes in the state’s Medicaid program.

The Democratic-controlled House voted 116 to 41 Wednesday to reject the Republican governor’s proposed amendment to the state’s $40 billion budget.

The vote came one day after legislative hearings were held on Baker’s Medicaid package, which among other things would move an estimated 140,000 non-disabled people off MassHealth and into subsidized insurance provided through the state’s Health Connector.

Critics say that would mean higher costs and reduced benefits for many low-income families.

The vote makes it likely that businesses will pay the new fee, which Baker has argued should be linked with cost-saving Medicaid reforms.

Democrats aren’t ruling out later action on some of the proposals.