Hickman and Bingman agreed the only way the cigarette tax can get through the Legislature is as a referendum, which means a vote of the people. The state constitution requires revenue increases be approved by three-quarters of both the House and Senate — something that’s not been done in the 25 years the provision has been in place.

“I just don’t think there is any way you are going to get 75 percent of the Legislature to vote for a tax increase,” Bingman said.

Hickman said getting to the required 76 votes in the House would require help from the minority Democrats, and he doesn’t expect that.

House Democrats have generally opposed any revenue measure this session that does not include repealing a 0.25 percent cut in the top state income tax rate that went into effect Jan. 1.

The “rebalancing” plan is, in essence, an alternative to the Affordable Care Act’s expanded Medicaid, but no one with the Health Care Authority wants to say that, for fear it will bring out the opposition.

Instead, it touts lowering the number of Medicaid recipients by up to 20 percent while reducing the number of uninsured and generating $3 billion in economic activity.