More than 150,000 Arkansans have gained coverage under the private option — the state's unique policy using Medicaid funds to purchase private health insurance for low-income residents — but the future of the policy could be in jeopardy depending on the outcome of several Republican primaries this Tuesday in state legislative races.
"I think it's the big major issue," said Sen. Bryan King (R-Green Forest), one of the most vocal critics of the private option. "As a Republican, when you campaign on less government and then you vote for the largest expansion in government in Arkansas history, it's definitely going to be an issue."
"I feel that this is an expansion of Obamacare into Arkansas," said Scott Flippo, owner of a Bull Shoals nursing home, who is running for an open state Senate seat against Rep. John Burris (R-Harrison), one of the key Republican architects of the private option (a third candidate in the race, Mountain Home mayor David Osmon, supports the policy). "The private option is the overriding issue in this campaign."
"I don't think the race will be decided by the private option," Burris said. "I think it could be decided by my opposition lying to the voters continually and repeatedly by saying that I brought Obamacare to Arkansas. I think they're attempting to tell a lie so many times that it becomes the truth to voters. I think they're going to fail, but I think they're attempting it."
Most believe that Burris and Flippo will emerge from the three-way race in District 17 (which includes parts of Baxter, Boone and Marion counties) and face off in a runoff. That race is one of three GOP state Senate primaries that opponents and proponents of the private option will be watching closely. In District 9 (which includes parts of Crawford, Franklin, Scott and Sebastian counties), incumbent Sen. Bruce Holland (R-Greenwood), who voted for the private option, is being challenged by Rep. Terry Rice (R-Waldron), who voted against it. In District 14 (comprised of parts of Garland and Saline counties), another incumbent who voted for the private option, Sen. Bill Sample (R-Hot Springs), is being challenged by an opponent of the policy, retired financial auditor Jerry Neal.
The private option has popped up in numerous other legislative and statewide Republican primaries, with lawmakers who voted for the private option under heavy attack — even Sen. Missy Irvin (R-Mountain View), who flip-flopped from voting for the private option appropriation in 2013 to voting against it this year, drew a primary opponent criticizing her original vote.
Irvin is expected to win re-election easily, but the other senate races are viewed as close calls. They are drawing particular attention because the margins in the General Assembly are so tight: In order to accept the federal money to fund the private option, both houses of the legislature must approve the appropriation by a 75 percent supermajority, a devilishly high bar. In the 2014 fiscal session, the private option was reauthorized with no votes to spare in the Senate and one vote to spare in the House. Votes in the House have been relatively fluid, but the rump group of eight Republican opponents in the Senate appears to be unmovable. Moreover, while each of these individual races will be decided by personalities and policies beyond the private option, the post-election narrative will focus heavily on the health care issue. Republican lawmakers on the fence about the private option going forward may make a political calculation based on what happens next week.
"A lot of what transpires over the next year will be determined [by these primaries]," said Sen. David Sanders (R-Little Rock), one of the key Republican backers of the private option.
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