UPDATE, 12:35 p.m. ET: The Medicaid funding bill failed again Friday in the House, but more votes have been scheduled for next week.
Less than a month ago, the prospects for Obamacare’s Medicaid expansion in Arkansas looked dire. The state had already expanded the program this year, but the legislature needed to approve its funding again. Conservatives confidently predicted that they had enough votes to block next year’s funding. Insurance for more than 80,000 people hung in the balance, creating the real possibility that people could actually lose coverage that they had gained under the law.
But, after a week of political horse-trading and inexplicable posturing, the program — and that coverage for low-income Arkansans — is on the verge of being saved.
The Arkansas Senate, where conservatives had pledged to make their stand, approved the funding Thursday by the 75-percent majority necessary under state law to keep federal money flowing for the program.
The House is expected to vote Friday, and most local observers anticipate it will pass. Democratic Gov. Mike Beebe is sure to sign it once it clears that chamber.
But it took a helluva lot to get here.
The Arkansas Times tracked the madness over the last three days. It started Tuesday as the House prepared to take the initial vote.
First, Democratic lawmakers threatened to hold out their votes unless a major insurance company pledged to increase reimbursement rates for specialist doctors. The insurer gave, resulting in a raise for specialists and a small cut for primary physicians.
They came around on that initial vote, but a number of Republican lawmakers held out and the funding bill failed Tuesday. To pick up some of those critical votes, a few provisions — including one that blocked state spending for outreach to help Obamacare enrollment — had been added to the bill.
Obamacare supporters didn’t seem to mind if it took a little pork to get the bill through. “It helped,” Beebe said. “If it takes 75 votes, it’s worth it if he’s the seventy-fifth vote.”
It wasn’t yet enough. The bill failed in the House again Wednesday. The reason, it seems, is House members didn’t want to be seen as the ones taking the first step toward approving Obamacare, preferring to leave that responsibility to the Senate. One lawmaker told the Times that Rep. Terry Rice (R), who is challenging Sen. Bruce Holland (R) in a primary, wanted to ensure that Holland voted in favor of Obamacare before he took his own opposing vote.
The Senate finally took the bill up Thursday. To get the necessary votes, following a special election that momentarily gave right-wingers enough clout to block the Medicaid funding, Beebe and Senate leaders had to give Sen. Jane English (R) a commitment about how $15 million in workforce training funding would be spent, funneling it to job training at two-year community colleges.
Asked if she actually supported the key Obamacare provision, English said: “Not really.”
“But sometimes you have to look at how do you do something bigger and better,” she said, touting that her job training funding should help people get off Medicaid.
She voted in favor and the funding bill cleared the Senate.
So that should have been it, right? Wrong.
Under the Arkansas Constitution, according to the Times, the two legislative chambers can’t vote on the same bill on the same day. So the House had to wait until Friday to take the final vote on the Senate bill that should allow funding for the Medicaid expansion to continue.
Anything could happen, but the Times’s sources say that the votes should be there, with enough House members assuaged by the various amendments and the Senate’s willingness to go first to give Obamacare their support.
But it certainly wasn’t easy getting here.