Analysis: Despite campaign rhetoric, the 'no' caucus on Medicaid plan shrinks under Hutchinson

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LITTLE ROCK, Arkansas — The "heck no" caucus on Arkansas' Medicaid expansion is turning into a very lonely place.

Winning over a coalition of supporters of Arkansas' private option and lawmakers who were ushered into office on vows to kill it, Gov. Asa Hutchinson cleared a major hurdle in his plan to continue the program while looking at longer term changes.

A larger fight may loom in the House, but the Republican governor is already showing an ability to peel away votes from anti-private option legislators who had once painted the November election as a referendum from voters against the first-in-the-nation program.

The Senate's vote to reauthorize the private option another year and create a task force to look at alternatives were the first major test of Hutchinson's attempt to thread the needle on an issue that's sharply divided his party. The private option, crafted as a compromise to expanding Medicaid under the federal health law, uses federal funds to purchase private funds for the uninsured.

Both measures sailed through the chamber without any floor speeches against them, a stark contrast to past fights and last-minute negotiations over the Medicaid expansion. Hutchinson's plan even won the backing of outspoken private option opponents who tried to distance themselves from repeal efforts they once embraced.

"There's some people that only see one thing and that's immediate repeal," said Sen. John Cooper, R-Jonesboro, who was elected to the Senate after campaigning to kill the program. "It's been a long time since I thought an immediate repeal was workable. ... I don't think it is now."

Sen. Cecile Bledsoe, R-Rogers, who chairs the Senate Public Health Committee and has also opposed the private option in the past, said she viewed the approach as the best way to phase out the program.

"If we can't have it end in 2015, we'll have it end in 2016, and that's fine," Bledsoe said.

The two senators who voted against both measures were freshmen Republicans elected last year on anti-private option campaigns. One of them, Sen. Linda Collins-Smith of Pocahontas, said she believed there would be fallout for Republicans who campaigned against the compromise expansion but voted to continue it.

"There is a mandate from the people. They've spoken loud," said Collins-Smith, whose proposal to repeal the program later this year failed before a Senate panel last week. "You can't misunderstand that."

If Hutchinson's approach succeeds, it tees up a bigger fight next year when lawmakers face another vote on the private option's reauthorization and likely on whatever recommendations the task force on its future delivers. In the interim, the attention will shift to the 16 lawmakers who are looking at options that could range from a retooled version of the private option to a complete overhaul of the state's Medicaid program.

But the most immediate concern is the House, where leaders hope to take up the funding and task force bills quickly. There are 41 freshmen in the 100-member chamber, including many who campaigned against the program.

The private option survived at least one test in that chamber last week, with the House Public Health Committee rejecting a plan to repeal the program this year. The next comes as early as Tuesday, when the same panel is expected to take up the task force proposal. House leaders say they want the chamber to take up that proposal the same day members vote on the reauthorization.

Hutchinson expressed optimism about the chances of his approach passing the House, casting the Senate's vote as a sign of broad support on an issue that's dominated the Legislature over the past three sessions.

"Obviously there's been debate as to when and how, but this is the consensus resolution," Hutchinson said.


Andrew DeMillo has covered Arkansas government and politics for The Associated Press since 2005. Follow him on Twitter at http://www.twitter.com/ademillo

An AP News Analysis

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