Ark. House Fails To Renew Funding for Alternative Medicaid Expansion

An Arkansas appropriations bill that would have continued funding the state's Medicaid expansion plan for a second year fell five votes short of final passage in a House vote on Tuesday, the Wall Street Journal reports (Campoy/Radnofsky, Wall Street Journal, 2/18).

Under the "private option" plan, which CMS approved last fall, Arkansas would use three years of federal funding meant for the Medicaid expansion to help residents purchase private health insurance through the state's health insurance exchange. The funding helps subsidize private insurance coverage for more than 200,000 state residents with incomes up to 138% of the federal poverty level (California Health Line, 10/1/13).

The alternative plan -- which garnered narrow approval in the GOP-led Legislature in 2013 -- is facing fresh opposition from Republican critics who have intensified their attacks against the ACA ahead of this fall's state elections. The plan's opponents have gained two more supporters, increasing the likelihood that they will be able to block a reauthorization of the plan this year.

Last week, state Rep. Nate Bell (R) introduced amendments that would curtail the state's ability to promote the alternative program in order to gain back Republican support for the plan (DeMillo, AP/Washington Times, 2/12).

However, the House on Tuesday voted 70- 27 on the bill with the new reauthorization language. The bill required 75 votes to advance under state legislative rules (Brantley, "Arkansas Blog," Arkansas Times, 2/18).

Arkansas Gov. Mike Beebe (D) -- who championed the alternative plan -- on Tuesday warned that failure to reauthorize funding for the plan could create a $90 million state budget deficit.  According to the governor's office, about 50% of the 218,000 state residents expected to sign up for program had already enrolled in coverage (Wall Street Journal, 2/18).

House To Vote Again Today

Arkansas House Speaker Davy Carter (R) -- who also supports the private option plan -- said Tuesday that the chamber will take up the legislation again on Wednesday and each day of the current session until the measure is passed, the AP/Columbia State reports. However, Carter noted that he will not make any further changes to the legislation (DeMillo, AP/Columbia State, 2/18).

According to CQ HealthBeat, the outcome of Wednesday's House vote could be different because one lawmaker on Tuesday voted "present" and four others did not vote (Adams, CQ HealthBeat, 2/18).

Senate Likely To Approve Similar Measure

The state Senate also is scheduled to vote on an identical measure Wednesday (AP/Miami Herald, 2/19).

According to the AP/Columbia State, Senate leaders believe they have the 27 votes necessary to pass the measure after securing the approval of Sen. Jane English (R), a lawmaker who opposed the plan last year but has agreed to support it this year in exchange for changes to the state's workforce training program (AP/Columbia State, 2/18).