LITTLE ROCK — Gov. Mike Beebe was extolling the benefits of the so-called private option for expanding health insurance coverage last week when a reporter asked him why winning legislative support for the program does not seem to be any easier now than it was in the 2013 legislative session.
“It should be. I don’t know,” Beebe said. “You’ll have to ask them. I can speculate, as I expect you can, but I’m not going to.”
A factor that the governor may have been too discreet to name is election-year politics. The fiscal session that begins Feb. 10 will be followed by a May 20 primary election in which Arkansas’ program to use federal Medicaid money to provide private insurance to the working poor is sure to be an issue in some Republican races.
That became apparent last week when Heber Springs schoolteacher Phil Grace announced he will challenge Sen. Missy Irvin, R-Mountain View, for the Republican nomination in state Senate District 18.
Grace said in a news release he is “firmly opposed to Obamacare in Arkansas and legislation that helps implement any part of it, such as Medicaid expansion under the private option.” He said he believes voters in the district are troubled by “my opponent’s record of voting for the largest government expansion in Arkansas’ history, known as the private option.”
Irvin has said she plans to reverse her previous position and vote against appropriating federal funding for the private option during the fiscal session. Another senator who voted for the private option last year, Democrat Paul Bookout of Jonesboro, resigned amid an ethics scandal and has been replaced in a special election by Sen. John Cooper, R-Jonesboro, who has said he will vote to defund the program.
The original appropriation for the private option passed with 28 votes in the 35-member Senate last year. Appropriations bills require a three-fourths majority vote, so the funding passed in the Senate with one vote to spare — making the apparent loss of two “yes” votes in that chamber a significant roadblock to winning renewed funding.
Beebe said he believes some legislators who voted against the private option last year will vote for it this year. He said many of those who voted against it did so because they questioned whether the federal government would allow everything the state was requesting, and “all of those questions are answered now, in the affirmative. We got what we asked for.”
State Department of Human Services director John Selig has said enrollment in the program is going well. As of Jan. 25, 98,145 people had been determined eligible and 79,182 had completed the process; between 200,000 and 250,000 are expected to enroll eventually.
A legislative audit report released last week concluded that the private option is in compliance with state laws and the federal Medicaid waiver that allowed its implementation.
A Talk Business-Hendrix College poll conducted Jan. 19 through automated phone calls found that more Arkansans want the private option to continue than want it to end. Of the 520 likely voters polled, 47.5 percent said the program should continue, 32.5 percent said it should end and 20 percent did not know. The poll’s margin of error was plus or minus 4.3 percent.
Hal Bass, a political science professor at Ouachita Baptist University, said some legislators may have sincere philosophical objections to the program, but some conservative Republican lawmakers also may be concerned about “being outflanked by even more conservative folks” in primary races.
“Primaries do tend to bring to the fore the more activist among the voters, and they tend to be, and this is not an iron law or anything, but they tend to be the more ideologically rigorous, even extreme, among the voters,” he said.
Campaign cash is another factor. Americans For Prosperity, a group backed by billionaire brothers Charles and David Koch, has backed challengers to Republican legislative incumbents in the past when it felt the incumbents were not conservative enough.
“I think a lot of national money has figured out that you can have a lot of impact on state-level policy for a fairly small investment — that is to say, you can get an awfully big bang for your buck by investing at the state and even local level,” Bass said.
He noted that legislators would not be voting on the private option in an election year if not for the 2008 decision by voters to go from biennial sessions to annual sessions. Previously, legislators only convened for regular sessions in odd-numbered years.
“Under the old rules, we’d have had another year to get it even more established, institutionalized, before the Legislature had another shot at it,” Bass said.
Some have floated the idea of postponing a vote on the private option until after the May primary election, to ease the political pressure on legislators. It’s not an idea that Beebe supports.
The governor said last week that with $89 million in expected savings from the private option built into his balanced budget proposal, the budget and the private option are linked together.
“We’re supposed to come out of this fiscal session with a budget, and we will,” he said.