Bruce Westerman
LITTLE ROCK — The approval of the “private option” that Arkansas is pursuing to expand health insurance in the state doesn’t end the debate over an idea that supporters have touted as an innovative way to reform Medicaid and opponents have blasted as no different from “Obamacare.” It’s merely a preview of the fights yet to come.
As lawmakers prepare to wrap up a legislative session highlighted by a very public split within the new Republican majority over the health insurance program, they’re facing the likelihood of renewing that dispute in less than a year — both in the Capitol and on the campaign trail.
Democratic Gov. Mike Beebe is expected on Tuesday to sign into law the measure, which would allow Arkansas to use federal Medicaid dollars to purchase private health insurance for thousands of low-income residents through the exchange created through the federal health law. It’s an idea that Beebe and some Republican lawmakers have promoted as an alternative to the Medicaid expansion called for under the new law.
“It’s taking something that most Arkansans would never have approved and making it better,” Beebe told reporters after the plan received the final legislative OK. “And making it fit for Arkansas.”
But the debate over the measure laid bare the divide among Republicans in the state over how to grapple with a federal law that GOP candidates have successfully run against during the past two election cycles. Supporters of the plan argued that it would mitigate the consequences of that law — namely penalties businesses would face for not offering employees health coverage — while also reforming Medicaid.
“If you push the red button or yellow button, you’re voting for the D.C. version of Obamacare,” Republican Rep. Charlie Collins, the chairman of the House Revenue and Taxation Committee said, referring to the lights indicating a “no” or “present” vote.
But the top Republican in the House issued a stern warning to fellow GOP members if they considered backing the measure.
“To my friends who are considering voting for this appropriation, but doing so against the convictions of your heart, I ask you this: Is this vote worth 30 pieces of silver?” Majority Leader Rep. Bruce Westerman, R-Hot Springs, told lawmakers.
The argument is likely to be renewed on the campaign trail next year, with some conservative activists and groups complaining that Republicans who supported the plan were going against their past opposition to the health care law. Supporters of the plan, however, are arguing that not enacting the insurance program would have meant a tax increase for businesses around the state.
It’ll also spill over into the fiscal session next year, when lawmakers return to the Capitol to focus primarily on crafting the state’s budget. That session could involve another hunt for a slim super-majority — 27 in the Senate and 75 in the House — to approve the budget bill for Medicaid and the private option.
Supporters of the private option proposal, however, aren’t shying away from that possibility. They say the Legislature voting again on the budget for the program next year gives the state leverage as it asks the Obama administration for approval to move forward with the plan.
They say the three-fourths vote the budget bill will require each year joins other protections in the bill that prevent the program from being implemented if the federal government doesn’t agree or if federal funding falls below promised levels.
“That’s always been my point for people who were hoping for circuit breakers, we’ve got circuit breakers every year because we’re back here trying to pass the appropriation bill,” Rep. John Burris, the House Public Health Committee chairman and a chief backer of the plan. “So this isn’t a one-stop deal. We passed the plan, the triggers are in place, they need to honor that and respect it and do what it takes to implement that plan fully. Because if they don’t, they won’t get that three-fourths vote when it comes time to renew that appropriation.”
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