A bill that would allow low-income Arkansas residents to buy private health insurance using Medicaid dollars passed the Arkansas House on its second try by a vote of 77-23.
Some members burst into applause after the vote. Seventy-five votes were needed for passage. It fell six votes short on the first vote Monday.
The bill next heads to the senate, where it will also need a three-fourths majority or 27 votes. It wasn't immediately clear when that vote will be.
"I commend my colleagues who have just cast a difficult vote in favor of the 'private option,'" House Speaker Davy Carter said in a statement. "With their support, Arkansas now leads the nation with a conservative alternative to the policy forced upon us by the federal government."
Gov. Mike Beebe commended the vote afterward, calling it a "victory for the people."
"It's not a win for me," he said in a news conference in his conference room shortly after the vote. "It's not a win for those legislators. It's a win for the people. I really think that this is the best thing for the people — not just the ones affected. You and I and the rest of us around here who already have health insurance ... will be positively affected because there will be less uncompensated care."
Beebe would not speculate on how the bill is likely to fare in the senate.
Carter met with reporters later Tuesday, saying he was confident going into the day that he had enough votes for the private option bill to pass. That was a stark contrast to the beginning of the session, Carter said.
"I was surprised whenever we first started learning the federal government would be open to anything less than full-blown expansion under the Affordable Health Care Act," he said. "If we had taken a vote on the first day of the session, it would have failed miserably. I didn't support it. There was just no support yet for that at all. But that only supports how far we have come."
Before the vote, several members spoke for and against the bill, which is known at the Capitol as the “private option.”
Rep. Nate Bell, R-Mena, said some of his colleagues received "threats and intimidations against their families, their livelihood and their reputation."
"Today as I stand before you, I want to ask you this one question: When you look deep in your heart do you want to be on the side of threats and intimidation or do you want to vote what's in your heart? You know the truth, you know the right thing to do."
Rep. John Burris, R-Harrison, spoke in favor of passage, calling the vote likely the "most conflicted decision any of us will ever make in our life because it literally affects hundreds of thousands of people."
"I know that we're all under pressure, but that's a lot different than threats," he told the members. "I'm voting yes because I think it's the right thing to do and I think it's the best policy for the state of Arkansas."
One member indicated she was changing her mind and supporting the bill after previously being against it.
Rep. Sue Scott, R-Rogers, appeared to pause with emotion while she described small-business owners contacting her and urging her to support the private option bill.
"So when I push either a red or green button this morning, there will be a face on it," she said. "Or several faces. Maybe the mother of five who called me this morning at 6:30 who said we all work at our business because we have to. We can't afford to hire anyone else ... I am going to vote for this. I had originally said I would not. But I've had too many phone calls from too many good, hardworking people — not lobbyists."
Rep. Randy Alexander, R-Fayetteville, said he is convinced that the private option bill is the "best of the two lousy Obamacare options we have to choose from."
But Alexander took to the House floor before the vote and urged his members not to support it because he wants at least two weeks to meet with constituents.
"How can we possibly expect our constituents to be comfortable with this vote?" he said.
On Monday, representatives voted 69-28 in favor of the appropriations bill, but a three-fourths majority is needed to pass such legislation in both the House and the Senate.
The House quickly adjourned that day, only to reconvene Tuesday morning to vote again on the bill.
The House on Thursday passed House Bill 1143, sponsored by Rep. John Burris, R-Harrison, and Senate Bill 1020, sponsored by Sen. Jonathan Dismang, R-Beebe, which are identical bills that would allow the state to create a program that would allow 250,000 low-income residents to purchase health insurance using government funds.
HB1143 and SB1020 passed the House with 62 and 63 votes Thursday.
A July decision from the U.S. Supreme Court on the federal health-care law allowed states to choose whether to extend Medicaid access to those making up to 138 percent of the federal poverty line, or $15,145 for an individual. It also calls for states to set up a private insurance marketplace for people to pick their own plan.
In a February meeting in Washington, D.C., U.S. Health and Human Services Secretary Kathleen Sebelius gave Gov. Mike Beebe approval to pursue the plan, and recently gave written confirmation in a letter to Beebe that the federal government supported Arkansas' "innovative approach" to expanding health insurance.
Monday's failed vote came after House Speaker Davy Carter decided to postpone the vote, which was originally scheduled for Friday. House members requested the postponement to have the weekend to discuss the appropriation with their constituents.
Read tomorrow's Arkansas Democrat-Gazette for full details.