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The rejection was driven by conservative Republicans in the state Senate, who thought that accepting the funding tied Oklahoma too closely to the federal health care law. They also rejected legislation setting up an exchange run by the state — a decision that disappointed the governor.

On another issue, Mrs. Fallin said she strongly backed an expansion of the $7 billion Keystone XL pipeline project to bring tar sands-based Canadian oil through the heartland and Oklahoma and on to markets in the Gulf Coast. State oil and gas interests strongly favor the pipeline, but environmentalists have raised questions about its safety.

Mrs. Fallin said she and state officials have pressed Secretary of State Hillary Rodham Clinton to approve the project, with a decision expected in the coming weeks.