Arkansas Lawmakers Pass 'Private Option' Health-Care Law - Program Allows State to Use Medicaid Dollars to Buy Private Health-care Insurance for Some

From The Wall Street Journal:

Arkansas lawmakers voted Tuesday to continue allowing the state to use Medicaid dollars to buy private health-care insurance for poorer residents, overcoming resistance from some Republicans who said the program amounted to an endorsement of the Affordable Care Act.

Arkansas last fall became the first state to offer a "private option" to extend coverage to lower-income residents, the result of a compromise between state Republicans and Democrats over how to implement a crucial provision of the health law. The program, endorsed by the Obama administration, was seen by supporters in Arkansas as a way to accept federal dollars and cut the number of uninsured residents without enlarging Medicaid.

The program was watched closely by other states, which had adopted similar programs or weighed doing so, but it became a tough political fight in Arkansas, reflecting overall unease with the health law's expansion of coverage.

After several failed votes to reauthorize money for the program last month, lawmakers in the state House narrowly approved a measure to continue the program and ensure that nearly 100,000 state residents now participating in it would continue to receive health-care coverage. The tally was 76 to 24, just above the 75 needed for passage under legislative rules.

"I'm very proud of the members, the Democrats and the Republicans," said House Speaker Davy Carter, a Republican. "This has been a divisive issue, and we all came together and put that aside."

The state Senate had passed an identical bill last month. The measure now goes to Democratic Gov. Mike Beebe, who is expected to sign it into law.

The Arkansas plan was devised by Mr. Beebe and state Republicans as an alternative way of accepting the law's federal funds for expanding eligibility for Medicaid to extend health coverage to as many as 218,000 uninsured residents. It was completed just days before the Oct. 1 rollout of the online insurance portals where people may sign up for coverage.

Similar plans have been implemented in Iowa and Ohio and are being considered in Pennsylvania, Tennessee and Utah. Those Republican-led states are seen as key to the Obama administration as it tries to persuade a majority of states to agree to some kind of expansion of coverage for their lowest-income residents. The Supreme Court ruled in 2012 that states could opt out of that part of the 2010 health law.