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The Future Of The Obamacare “Private” Option: DOA In The Senate?

Senator-elect Terry Rice

After Tuesday night’s election results, the future of the Obamacare “private” option appears even shakier. That’s because the anti-PO caucus was successful at moving one of their leaders from the House to the Senate; this could roadblock the PO in the 2015 session.
As I reported yesterday, Rep. Terry Rice was successful in his bid to unseat incumbent Senator Bruce Holland in District 9. Rice has been a strong, consistent opponent of the “private” option since its inception. Holland, on the other hand, was a PO booster, even campaigning on the issue. With no Democrat on the ballot, Rice will be unopposed in November. He will be the next senator from District 9.
I spoke with Rice after his victory to get a sense of where the PO debate is headed. He predicts that the program on the state level — and Obamacare as a whole — will continue to unravel:

There’s a lot of factors that play out. One thing that I think we will have is more information. While I welcome any new information, positive or negative to view facts on, I think the uncompensated care information that they brought out last week — it’s gotta be better. I think I heard the program for 2015 is supposed to be $1.5 billion overall. If you put enough money in something, you’re going to change some outcome. And what it boils down to is: what is affordable? What can the state afford? What are the feds gonna be willing to pay?

As for what type of battle we should expect, Rice said:

There’s a number of dynamics that I think we have to plan out as well as the history these coming months before the 2015 session. I’m not making any raw comments saying we’re going down there for a gunfight or anything. I think the facts and figures are going to spell it out for themselves and I think there’s a lot of things that will continue on with the federal plan that may change.

I asked Rice if he could say at this point how he will vote on the program. He didn’t give a straight yes-or-no, but emphasized that he’s consistently opposed the program, that it’s unsustainable, and that nothing has materially changed that would alter his position:

I don’t see right now — I’ve fought against it every time. The majority of Arkansas has been against this…I don’t think it’s got sustainable funding.

As for any concerns about “kicking” people off of the plan (considering we now have 150,000+ people enrolled) Rice said:

You need to give them some leave time if you’re going to, but if the money gets cut off, you’re gonna be throwing [them off] — because that’s what Governor Beebe told me when he was trying to negotiate with me. I said, “Governor, what are you going to do when the money’s not there?” He said, “All you can do is cut them off.” I said, “Have you ever seen a quarter million people cut off of government welfare?” He didn’t have an answer. And that’s what I want to avoid.

Finally, Rice said he’s hopeful that the conversation will begin to change because the program is not sustainable over the long-term:

That’s the dynamics that I pray that’s going to change the whole discussion. I think the pro-POers will be forced to see where we’re at. It’s not sustainable. I don’t see a way in the world.

With Rice heading to the Senate, there is no margin of error for getting the “private” option funding through in the 2015 session. (For those of you who don’t know, appropriations bills need 75% support to pass each chamber. In the Senate, this means the PO funding will need 27 votes. Right now, based on the numbers from last session, they currently stand at 26 votes, or one short of the votes they need.)
With that said, no one knows how Senator Missy Irvin will vote on the program in the next session. She was against it before she was for it before she was against it. She could easily flip back to a yes vote, putting the PO over the 27 vote threshold and continuing the program for another year. However, there is one more wild card still on the table: one pro-PO vote is not returning to the Senate.
In Senate District 17, Senator Johnny Key, a reliable pro-PO vote, is not seeking re-election. So, with Holland on his way out, that puts the PO funding currently at only 25 votes. The PO camp is hopeful they can put Rep. John Burris over the top and secure a much-needed vote for the program, but he’ll have to beat businessman Scott Flippo — a lock vote against the PO —  in a June 10th runoff. If Flippo wins, there will be 9 solid votes against the PO in the senate, enough to block it. If Burris wins, there will only be 8 solid no votes, making Senator Irvin the swing vote once again. (There is also potential for another anti-PO pickup in Senate District 19, where former Rep. Linda Collins-Smith is running against Rep. James McLean for the open seat. If Collins and Flippo are both successful, there will be 10 solid votes against the PO in the Senate.)
For now, it looks like Senate District 17 is ground zero in the battle over the Obamacare Medicaid expansion in Arkansas.

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