The state House of Representatives has voted for a fourth day in a row not to approve funding to continue Arkansas's private option Medicaid expansion.
The House voted Friday morning 71-18 on the Senate bill, falling short of the required 75-vote supermajority for passage.
The Senate passed its bill 27-8 Thursday, but the House has been falling short all week. Seventy members voted yes on Tuesday, 68 on Wednesday and 72 on Thursday.
House Speaker Davy Carter said the House will vote again when it next convenes at 1:30 p.m. Tuesday.
"We're going to get this issue resolved," he said. "There's no question to that. There are 100,000+ people out there that are literally hanging on what we do up here. This is serious business. This membership is going to take it seriously and we're going to get this issue resolved."
Before the vote Friday, Rep. Mark Lowery, R-Maumelle, addressed the members and said he would be voting yes after voting present the first three days. Carter said afterward that he was told Friday by Rep. Les "Skip" Carnine, R-Rogers, that he would vote no and wouldn't shift from that.
Still, Carter expressed optimism that the vote would eventually reach 75.
"The message is very clear," he said. "I don't know how to say it any more clear. The reality is this is the bill. There aren't enough votes to amend the bill, to send it back to budget, to do anything different. So that's just the reality. And it's time that we deal with this because we have a lot of other bills to deal with. We have to set a budget for this entire state that we can't do because we're down here playing games."
There was some drama as the vote Friday approached and Carter learned one member, Rep. John Payton, R-Wilburn, had left the chamber early after pairing with an absent member for the vote.
Carter called a recess and ordered state police to locate Payton.
"On my desk, I had a pairing form that he signed that said he was here," Carter said. "... I expect him to be here. Would I rather have not even had to do that? Yes. But, you know, we've got to be here. There's some members that want to play games, but this is going too far."
Carter said the issue was ultimately resolved when Rep. Stephen Meeks agreed to sign the pairing sheet in Payton's absence.
The vote was held moments later.
The private option narrowly passed last year but since lost at least two votes in the Senate. The chamber reached 27 votes after Sen. Jane English, R-North Little Rock, agreed this week to support it in exchange for the creation of a statewide workforce-training initiative.
Carter vowed at the start of the fiscal session last week that the private option would pass both the House and Senate, adding that failing to do so would create an about $90 million hole in the budget. After each failed vote, he said the House would continue to vote — and would not engage in further negotiations — until it passed.
"We're making progress," he said Thursday, expressing confidence the votes will ultimately come together for passage. "Yes, the bill will pass, yes it will be that bill. There will be no amending it, altering it in any form or fashion. And it will pass. Whether that's [Friday] or Tuesday or Wednesday, I don't know."
The private option plan allows the state to buy private insurance for Arkansans with incomes of up to 138 percent of the poverty level using federal Medicaid money.
The program initially is covered entirely by federal funds, but the state by 2020 would have to pay for 10 percent of it.