We're definitely closer to passing expansion than we've ever been, with legislation moving through the General Assembly and a significant group of Republicans actively pushing for the "private option." So why is the Expand-o-meter down a tick? Well, when it gets closer, it also gets clearer just how difficult it is to get to a super-majority. Just as some big names like Sen. David Sanders have come out in full support, some big names like Americans for Prosperity Regional Director Teresa Oelke have come out against. Any little thing — personal disputes, conflicts over other bills, fear of the next election cycle — can swing a wobbly vote. Ultimately, it comes down to the unpredictable idiosyncratic interests of individual legislators.
Encouraging news for expansion proponents:
• We finally got to stop using the "no Republican lawmaker has endorsed the private option" caveat, as first Speaker Davy Carter and Senate President Pro Tem Michael Lamoureux came out for the plan, followed by Sen. Jonathan Dismang, Rep. John Burris, Sanders and other prominent Republicans. And we finally got a bill, co-sponsored by Republican leaders.
• The feds released guidelines for private-option style expansion that confirmed the Arkansas framework and sent a letter directly to the state giving Arkansas a conceptual okay to the state's "private option" plan.
• Enabling legislation has passed the Senate and passed out of House committee. A House committee of the whole featured Rep. Burris making an impressive case for the "private option" and while it's hard to read too much into questioning, it looked like getting to 75 for the appropriation will be difficult but possible. Gov. Mike Beebe told reporters today that he's "cautiously optimistic," a view that seems to be shared among legislators in favor of the private option.
• After weeks of being cagey, Americans for Prosperity came out against the private option. Given that they spent more than one million dollars in the last legislative cycle, it's fair to say that they have the attention of lawmakers. They're now giving the hard sell, including an advertisement that mentions nothing about the actual policy but features clips of Nancy Pelosi. Meanwhile, a scattering of townhall meetings have cropped up, tea partying like it's 2009.
• Former Mitt Romney healthcare advisor Avik Roy flip-flopped from warm to cold on the private option after he realized that he had misunderstood the original policy framework. He's been advising Republicans to vote against the bill, though he may not have much sway over local legislators, particularly after getting the policy details of the Arkansas plan wrong on reimbursement rates, provider rules, and other matters.
• The biggest setback came from Rep. Bruce Westerman, who this morning removed his name from the bill as a sponsor and spoke to the House Public Health committee with a few half-baked arguments against the private option. He told reporters afterwards that he would vote no on the enabling legislation and the appropriation. Westerman probably moves at least a few "maybe" votes into the "no" camp.
Will the strong push from Sanders, Burris, Dismang and the Republican leadership be enough? The Expand-o-meter thinks so, but we're a thermometer, not a mind-reader. Things look pretty solid in the Senate, but in the House, there are around a dozen Republicans that remain wildcards. The future of the state is in their hands.
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