Burris Defeat, GOP Runoff Clouds Private Option Future in Arkansas

LITTLE ROCK — The Arkansas "private option" expansion of Medicaid again faces an uncertain future after one of its key architects was defeated Tuesday in a state Senate race cast as a referendum on the program.

Assisted living facility owner Scott Flippo defeated state Rep. John Burris in Tuesday's Republican runoff for a north Arkansas state Senate seat that had focused on Flippo's opposition to the state's plan to use federal Medicaid funds to purchase private insurance for the poor.

The defeat is a setback for the program that Burris helped craft as a conservative alternative to expanding Medicaid under the federal health law. The plan, approved last year, enjoys unanimous support from Democrats but has sharply divided Republicans who have made major gains in Arkansas by criticizing President Barack Obama's health law. More than 170,000 people have signed up for coverage under the private option, the first of its kind approved by the federal government.

With mailers that accused Burris of choosing Obama over his district, Flippo and his supporters weren't shy about portraying a former House leader who frequently railed against "Obamacare" as one of the law's biggest cheerleaders.

"Medicaid expansion is indeed a pillar of Obamacare, and so I feel that where Obamacare is the key, John Burrisgave him the ignition with the private option," Flippo said last week.

The private option had already been in a precarious position, narrowly winning reauthorization in March after several failed votes in the House.

Voters delivered a mixed verdict in the May 20 primary in several races that similarly focused on the private option. Supporters of the program who were handed defeats include state Sen. Bruce Holland, who was beaten by state Rep. Terry Rice. But Sen. Bill Sample, a Hot Springs Republican who voted for the law, survived a primary challenge from a rival who vowed to repeal the program.

A defeat for Burris, who was House minority leader in the 2011 and 2012 legislative sessions, complicates private option's prospects even further since keeping it alive will require three-fourths support in the House and Senate next year. There's no Democrat running for Senate seat in the fall, so Flippo will be in the legislature.

Burris, who is on leave as political director for U.S. Rep. Tom Cotton's Senate campaign, seemed an unlikely target to be portrayed as an ally of the president or his policies. Burris, 28, had once blocked the state Insurance Department's budget in an effort to prevent the state from setting up its insurance marketplace under the same law.

In arguing for the private option last year, Burris pitched the program as a way to implement conservative reforms to the state's Medicaid program.

"This is about as far away from Medicaid expansion as you could possibly get," he told House members last year.

The race had turned into a proxy fight between the same legislators who had debated over the program just months earlier, with lawmakers on both sides stumping throughout the state Senate district. An outside group that lobbied against the private option, Conduit for Action, had also sent out mailers attacking Burris for supporting the program.

Flippo, 34, echoed the complaints other opponents of the program have made, saying the state won't be able to afford the program once it eventually has to pay part of the cost and insisting that the state doesn't have as much control over the program as supporters say it does. The push against the private option is despite supporters pointing to signs that it is working, including a reported drop in the number of uninsured patients at many Arkansas hospitals.

Flippo's win also comes after legislative leaders said they had hoped to avoid the same prolonged debates over the private option that had marked the past two legislative sessions.

Sen. Jonathan Dismang, who will be the Senate's president in next year's session, said earlier Tuesday he hoped lawmakers could weigh the program without campaign rhetoric interfering. Dismang, who also had been an architect of the private option, had backed Burris' Senate bid.

"Even if (Flippo) ultimately chooses to vote against the program, I would like for him to at least spend the time to understand what we're looking at and understand the implications both good and bad and make a decision based on what's best for his constituency," Dismang, R-Beebe, said. "I understand that this is his central plank, but at the same time there's a difference between campaigning and legislating."

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