I’ve seen some dire-sounding headlines about the fate of Arkansas’s Medicaid program this week, but it’s helpful to remember that the Arkansas legislature was against the Medicaid expansion before they were for it last year, too.
The state voted to expand under a unique model (the so-called “private option”) early last year, but it survived a failed vote and a surprise amendment, first—and this was in April, following two months of intense debate and negotiation. After that, the waiver application had to withstand HHS’s scrutiny; the legislation contained a severance clause so that the whole plan would fall if the waiver wasn’t accepted as written. I was an ardent follower (and sometimes-commentator) during the private option’s infancy, and tensions were running much higher back then.
There is still some uncertainty about the private option’s fate; the legislature needs to authorize funds each year to the state’s Department of Human Services, which administers Medicaid. That’s the vote that has been happening this week; the Senate passed it yesterday, but the House has rejected it (twice). But a few failed appropriation votes are not quite the derailment that one might think (and to be fair, stories became increasingly accurate in this regard as the week wore on).
Here’s the real kicker about the hand-wringing headlines: if this stalemate wears on, the issue wouldn’t disappear; votes on departmental appropriations could hypothetically continue until July 1. That said, locals familiar with the political landscape think that the appropriation votes are there—this is just some classic Arkansas politicking—and that the appropriations will be wrapped up in short order, possibly later today.
I'd say chances of eventual supermajority passage of private option in #arleg House are 95%, but passing TOMORROW might be more like 50/50.
— David Ramsey (@ArkDavey) February 21, 2014
If you’re interested in actually tracking what’s happening, do yourself a favor and ignore sensational headlines. Follow David Ramsey, who’s on the ground in Little Rock; you can find him on Twitter and writing for the Arkansas Times blog.