The health-insurance exchange coming to Arkansas as part of the Affordable Care Act features subsidies to help folks making between 100 percent and 400 percent of the federal poverty level (FPL) buy insurance. There are no subsidies for folks making below 100 percent of the FPL because they were supposed to be covered by the Medicaid expansion. If the legislature says no to Medicaid expansion? Folks aged 19-64 making below 100 percent of FPL but above Arkansas's stingy income max for Medicaid will be left out in the cold. That would leave a hole in coverage that looks pretty ugly: poor folks without kids or making more than a fraction of FPL have no safety net, while the government subsidizes (relatively) more affluent citizens.
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