LITTLE ROCK — The state House on Tuesday voted 76-24 to appropriate a new round of federal funding for the so-called private option, resolving the issue that has dominated the fiscal session.
The Senate passed the $915 million appropriation last month in a 27-8 vote. The House failed in four previous attempts to pass it, each time falling a few votes short of the three-fourths majority, or 75 votes in the 100-member House, needed to approve any appropriations bill.
Senate Bill 111 goes next to the governor, who said Tuesday he would sign it.
"This means a lot. It means a lot for the state," House Speaker Davy Carter, R-Cabot, told reporters after the vote.
"I’m proud of the members, I’m proud of everybody coming together," he said. "I think the story is about political courage. I think it’s about Arkansas doing something different than the rest of the country. I think we are moving towards market-based health care, coupled with the reforms we’ve put in place. I hope the rest of the country is watching, because Arkansas has tackled this issue, in my opinion, together, better than anybody else in the nation has."
"Obviously I’m pleased," Gov. Mike Beebe said, noting that the bill’s passage with a vote to spare was a surprise after the House’s previous struggles to pass it.
The private option is Arkansas’ alternative to the expansion of state Medicaid rolls that was proposed under the federal Affordable Care Act. The state obtained permission from the federal government to use the federal Medicaid money that would have gone to state Medicaid expansion to subsidize private health insurance for people earning up to 138 percent of the federal poverty level.
About 94,000 people have enrolled in private plans through the program, and another 11,000 who applied have been enrolled in traditional Medicaid because that program is more suited to their needs, according to the state Department of Human Services. About 105,000 people have applied since the program launched in October.
Carter said previously that if the measure did not pass Tuesday the Legislature could either go into a temporary recess or end the session without completing the budget process. Tuesday’s vote apparently made those options unnecessary.
Beebe had said that defunding the private option not only would take insurance away from more than 100,000 Arkansans but also would require adjusting his proposed budget to eliminate $89 million in anticipated savings from the program.
Opponents have questioned whether the state will be able to afford its eventual 10 percent share of the program’s cost. In debate on the House floor Tuesday, Rep. Joe Farrer, R-Austin, asked, "How are we going to pay for it?"
Rep. Kim Hammer, R-Benton, said on the House floor that he had decided to vote "yes" after voting against the appropriation earlier in the session.
"There are people that would be hurt if I don’t vote for this, and I don’t want to see those innocent people get hurt because of that," he said, adding that he would continue to fight for changes to the program and that he would vote against it next year if it does not produce the promised results.
Also voting for the program, after voting against it as recently as two weeks earlier, were Reps. Skip Carnine, R-Rogers, and Mary Slinkard, R-Gravette.
Carnine said later he has many reservations about the program, but he said the Legislature will have other chances to revisit it.
"Now was the time to move on," he said.
Last week, some legislators had discussed the possibility of creating a limited enrollment period each year for the program as a way to win more votes. That idea ultimately was dropped, DHS Director John Selig said Tuesday, noting that some lawmakers did not like the prospect of placing people in traditional Medicaid if they applied outside of the enrollment period.
The Legislature did amend the appropriation earlier in the session to bar the state from promoting the private option or the Arkansas Health Insurance Marketplace and to do away with the guides and navigators who have been helping people enroll in the marketplace. Rep. Nate Bell, R-Mena, proposed that amendment as an intended compromise between opponents and supporters of the private option, but in the votes taken immediately after the amendment was adopted, only Bell switched from voting "no" to "yes."
Carter said Tuesday the Legislature should be able to wrap up the session quickly now that the private option funding has passed, although he did not know whether that could happen this week.