Arkansas lawmakers will try once again to provide funding this week for the state's Private Option medical insurance plan that has drawn interest from other states' lawmakers, who see it as an alternative to Obamacare.
The Arkansas Senate approved the $915 million appropriation for the Private Option plan last week, but the House narrowly rejected it in four votes.
House Speaker Davy Carter, a Republican and a Private Option supporter, has expressed confidence that funding will eventually be secured. The House will probably vote on the bill on Monday, and every day after that until it passes, he said.
The program uses federal Medicaid funds from the Affordable Care Act, or Obamacare, to help buy health insurance coverage for low-income Arkansans, many of whom would otherwise be assigned to Medicaid or have their treatment costs absorbed by doctors and other healthcare providers.
This appeals to some conservative lawmakers who want to provide healthcare for the uninsured and believe a private-sector option makes more sense than enrolling more people in the federal Medicaid program.
It also fits into the plans of the Obama administration, which would like to see states use federal Medicaid money to provide some form of insurance for lower-income residents.
Both houses in the Arkansas legislature are controlled by Republicans, who are opposed to Obamacare and divided on whether the Private Option is a reasonable alternative.
The program, crafted by Republican legislators who worked with Governor Mike Beebe, a Democrat, was enacted last year.
"Republican governors and Republican states and anti-Obamacare and anti-federal government healthcare folks are saying, 'Gosh, we need to do what Arkansas is doing'," Beebe said in a Reuters interview last week.
The Arkansas experiment has since been adopted or considered for use in some form by several other states, including Republican strongholds such as Utah, and battleground states in presidential elections, including Pennsylvania, Michigan and Ohio.
"Pragmatic folks have said, 'We may not like it, we may have voted against it, but as long as we've got it, let's take care of our own people'," Beebe continued.
"From pure arithmetic, it's pretty much a no-brainer."
But opponents in the Arkansas General Assembly said that both the Private Option and the Affordable Care Act would prove financially disastrous and represent an unacceptable expansion of government.
State Representative Nate Bell, a Republican from Mena, Arkansas, and a leading opponent of the Private Option program, answered "both" when asked if conservative opposition to the plan was fiscal or philosophical.
Bell, who voted against the program in 2013, advocates passing the appropriation this year, but only after attaching amendments that he says could make it easier for the financing to wither in the 2015 legislative session.
Bell's language strips from the funding bill all money for outreach - advertising and marketing intended to increase enrollment in the Private Option - that its advocates say is important to broadening participation and holding down costs.
The Democratic governor and the program's legislative advocates have accepted that the amendments may be the price they have to pay to win the additional Republican votes needed to keep it funded.
Beebe has warned that failure to continue the Private Option would destroy his proposed $5 billion budget for the fiscal year beginning July 1 because the savings the program anticipates would compensate for millions of dollars in state tax cuts that Republicans demanded in 2013.
Last week, the 100-member House fell about five votes short of the 75 votes needed to continue funding.
"It boils down to Obamacare,"said state Senator Larry Teague, a Democrat from Nashville, Arkansas, and the co-chair of the legislature's powerful Joint Budget Committee.
Legislation with "any connection at all" to Obama's signature healthcare law is enough to doom it among some Republicans, Teague said.
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