HARRISBURG - The state House could decide as early as this week on whether Pennsylvania should become the 24th state to legalize medical marijuana.

The House began debate Monday evening on a legalization bill approved last spring by the Senate. Under the measure, people who suffer from certain conditions would be able to access medical cannabis in oil, ointment, and pill forms.

But as with all big-ticket bills in the Capitol that inspire deep divisions, it could fall victim to politics. The Republican-controlled chamber is considering a lengthy list of changes to the measure, which advocates say could make access more difficult for those who need it.

And several legislators privately grumbled that one of their colleagues, Rep. Matt Baker (R., Bradford), an opponent of the bill, appeared to be attempting to pull off a Washington-style filibuster Monday night - a preview of what could ensue when the measure comes up for a vote on final passage. That could happen as early as Wednesday.

Even if the bill passes the House, it is unclear whether the amendments the chamber appears certain to make are palatable to the Senate, where Democrats and Republicans alike have championed the issue.

Jennifer Kocher, a spokeswoman for Republicans who control the Senate, said the caucus was reviewing the proposed changes.

Gov. Wolf, a Democrat, supports legalizing medical cannabis and has said he would sign a bill if it reaches his desk.

"It is time to legalize medical marijuana, because we should not deny doctor-recommended treatment that could help people suffering from seizures or cancer patients affected by chemotherapy," he said in a statement Monday.

Already legal in states including New Jersey, medical marijuana is touted by its advocates as a safe and effective way to battle symptoms arising from a variety of conditions. The Senate bill covers conditions such as cancer, epilepsy, and post-traumatic stress disorder.

For months, the House has either blocked a vote on the measure or put off considering it.

Speaker Mike Turzai (R., Allegheny) opposes medical legalization. But Majority Leader Dave Reed (R., Indiana) is a supporter, and vowed this year to bring the measure up for a vote.

The main amendment the House approved Monday evening grew out of months of work by a bipartisan work group of House members and staff.

Though the amendment, sponsored by Rep. Ron Marsico (R., Dauphin), replaces the Senate measure, it largely tracks with what senators have approved.

Like the Senate version, it would cover a specific list of conditions. They include cancer, Parkinson's disease, multiple sclerosis, HIV/AIDS, and "intractable seizures."

Under the amendment, patients would be issued identification cards that would allow them to access medical marijuana from one of 150 dispensaries across the state.

Both growers and dispensaries would pay an initial application fee, registration fees, and annual renewal fees. A 5 percent tax would also be imposed on the gross receipts from the sale of medical marijuana by a grower to a dispensary.

"I believe this amendment earnestly and honestly helps people who need it most," Marsico said during floor debate.

Baker, who chairs the House health committee, spent more than an hour listing his objections to the measure - his chief one being that marijuana-derived treatments have not been approved by the U.S. Food and Drug Administration.

"Marijuana is a dangerous drug," said Baker. "We should not be legislating medicine."

But Rep. Mike Vereb (R., Montgomery) said listening to medical professionals as well as families with loved ones suffering from severe pain had convinced him of the necessity of legalizing medical marijuana.

He said there is "a full-blown epidemic staring us in the face" in Pennsylvania, with people becoming addicted to prescription opioids and heroin - and dying.

Said Rep. Nick Miccarelli (R., Delaware): "If this amendment saves any one life in our commonwealth, then it's worth trying."

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