On Monday, the Arkansas legislature convened a new session focusing specifically on fiscal issues. And at the top of the agenda is the effort to take away health insurance from about 96,000 people in the state.
Arkansas’ plan to expand Medicaid is currently on the chopping block, thanks to two key Republicans who say they oppose the policy. The state’s expansion won federal approval last fall, and the upcoming political fight will have tangible consequences for the tens of thousands of people who have already signed up for health care. If lawmakers don’t re-approve the Medicaid expansion during this fiscal session, those individuals will lose their new health plans by the end of June.
Last year, Arkansas Gov. Mike Beebe (D) figured out a way to extend health care to thousands of low-income residents by essentially striking a compromise between Republican lawmakers and the Obama administration. Arkansas accepted the federal money designated for states expanding Medicaid, but instead of using it to increase the Medicaid rolls, the funds went toward subsidies to help low-income people purchase private insurance. That compromise, which has been dubbed the “private option,” has served as an important model for other states where there’s a lot of political opposition to the government health program. Conservative lawmakers in Iowa, Pennsylvania, and Utah have been inspired to pursue similar Medicaid expansion plans.
But now, the balance is shifting in Arkansas’ GOP-controlled legislature, and the private option is in danger. Last month, Sen. John Cooper (R) won a special election after specifically campaigning on his opposition to the Medicaid expansion plan. Another Republican, Sen. Missy Irvin, recently changed her mind about the private option even though she supported it last year. That puts supporters of the plan down by one vote — and Democrats in the state are now worried that Medicaid expansion is “dead on arrival” in the legislature.
“If we lose one or two votes, it’s critical,” Beebe explained to Kaiser Health News, pointing out that Arkansas needs approval from 75 percent of the members of both houses to pass appropriations measures.
Aside from the immediate ramifications for the Arkansas residents who will no longer be able to afford health insurance, the unfolding fight also threatens to jeopardize similar Medicaid compromises in other states. “I do think it would have national repercussions if it were defunded,” Joan Alker, who heads Georgetown University’s Center for Children and Families, told the Washington Post. “I think a lot of it will come down to the perception why it happened and we’ll just have to see how it plays out.”
Before agreeing to the private option, Arkansas had one of the most restrictive Medicaid programs in the nation. A family of three with an annual income over $5,000 made too much money to receive assistance from the government program. And thanks to the state’s uninsurance rate, the private option is actually a smart financial decision — extending insurance to additional low-income families is estimated to save Arkansas about $90 million dollars in uncompensated health care costs.
Across the country, stubborn resistance to Obamacare’s Medicaid expansion will have stark consequences, particularly in Southern states that already struggle with high rates of poverty and uninsurance. An estimated five million Americans will lack access to affordable health care unless their lawmakers reverse their decision about the optional Medicaid expansion. And a recent study conducted by Harvard researchers found that the GOP-led states refusing to expand Medicaid will ultimately contribute to up to 17,000 avoidable deaths.