LITTLE ROCK — A preliminary House vote Wednesday on the private option for health care expansion failed to produce the tally supporters will need for approval of funding for the plan.
With key votes on the initiative’s enabling legislation and appropriation bill on the House agenda this week, a motion to amend the funding measure garnered 62 votes, enough for approval but well short of the 75 votes the appropriation bill itself will need to pass.
The chamber is expected to take up the enabling legislation for the private option — it needs a simple majority, 51 votes, for approval — on Thursday and the funding bill on Friday.
House Speaker Davy Carter, R-Cabot, who supports the private option, said he remained confident the House will pass both measures.
"I am still very optimistic that we’re going to have 75 or more votes on Friday," Carter told reporters after the House adjourned Wednesday.
While the House was meeting, Rep. Duncan Baird, R-Lowell, co-chairman of the Joint Budget Committee, presented an amendment to the appropriation bill, House Bill 1219, which would add triggers to ensure no money is spent if the federal government does not approve every aspect of the private option and an appropriation for a new state office of Medicaid Inspector General.
The office, which would be created under a bill that is currently working its way through the Legislature, would be charged with rooting out fraud, waste and abuse in the Medicaid program.
Rep. Joe Farrer, R-Austin, moved that the provisions be separated. Carter denied the motion.
The House voted by voice on the amendment, and Carter ruled that it passed. Some members then requested a roll-call vote, and the amendment passed 62-26.
Carter was asked later if the vote could be a sign that the appropriation bill is in trouble.
"I don’t know about that. The request from the floor was to separate them all out, so I don’t know what the dispute was about, if it was about that or about the substance of the amendments or not," he said.
Carter also noted that "there’s a lot of people that didn’t even vote on that deal."
Eleven members of the 100-member House did not vote on the amendment, including Carter.
Rep. David Meeks, R-Conway, said later that he voted against the amendment and plans to vote against the appropriation bill.
"There are still a lot of unanswered questions. … It’s not going to hurt us to wait a couple more months, get all those questions answered and then make a decision on whether to move forward or not," he said.
Carter, Senate President Pro Tem Michael Lamoureux, R-Russellville, and Gov. Mike Beebe have all said they want to see the issue resolved before the General Assembly goes into recess on April 19.
Rep. Kim Hammer, R-Benton, said he has not decided how he will vote on Friday. He said he voted against the amendment because "I want to see the appropriation split out. I think it’s an important enough issue that we need to treat it separate."
Carter said he denied the motion to separate the three issues because "that wasn’t what was on the table."
Under the private option, Arkansans earning up to 138 percent of the federal poverty level — $15,856 for an individual, $32,499 for a family of four — would use federal Medicaid dollars to buy private insurance through the state insurance exchange that is required to be in operation next year under the federal Affordable Care Act.
Officials say the private option would extend insurance coverage to up to 250,000 people who currently lack insurance. The federal government would pay the full cost of the expansion for the first three years, after which the state’s share of the cost would increase gradually to 10 percent.
Over the first 10 years the state would see a net savings of $670 million, according to a study commissioned by the state Insurance Department. The state Medicaid rolls are expected to shrink by about 35 percent as some people now served by the program become eligible for subsidies for private insurance.
Carter has been lobbying House members to vote for the private option, but lawmakers also have been hearing from opponents, including the conservative group Americans For Prosperity, which has opposed implementing any aspect of President Obama’s Affordable Care Act.
Carter said Wednesday he realizes that legislators have a tough decision to make.
"We’re here to be leaders," he said. "We need to quit worrying about the next election and do what’s right for the people of Arkansas."