Four incumbents in the Arkansas House and Senate lost in the primary elections Tuesday night, leaving candidates with runoff and general election challenges questioning how big a role the debate over the state's private option Medicaid expansion plan played in those defeats and leaving others to wonder what the program's future looks like.
The election results were mixed Tuesday for supporters and opponents of the private option, which uses federal Medicaid dollars to allow poor Arkansans access to private health insurance from a state-run exchange. But with three Senate races and 34 House races heading to a general election, and two runoff elections -- one in each chamber -- the program's future is still uncertain.
"From a practical standpoint, I think that so long as the majority of both chambers supports the policy behind it, it will continue," said House Speaker Davy Carter R-Cabot. "In order to change the law you have to have a majority of the membership not in favor of it. That's not the case now, and that is not going to be the case in the coming years. Twenty-six percent of the members don't rule."
But opponents of the program said they're hopeful after Tuesday's results. Rep. Joe Farrer, R-Austin, said he's been working with Sen. Bryan King, R-Berryville, to estimate the number of private-option opponents in each chamber. State law requires 75 percent of each chamber to approve most appropriations bills -- that's 75 of 100 representatives and 27 of 35 senators.
"I think the opposition vote in the Senate looks like it's going to be pretty solid. There was one seat last night, and there are solid no votes for two other races, meaning we could be looking at 11 opposition votes," Farrer said.
He said private-option opponents gained ground in the House Tuesday and were positioned for more gains in November.
"And that looks like we could have 29 or 30 votes in opposition," he said.
Farrer said people can change their mind, and he doesn't want to count on those promises until they translate into votes.
"You don't really know what people are going to do, until they do it," he said.
In the Senate, Bruce Holland, R-Greenwood, supported the private option and lost his primary bid, while another private-option supporter, Sen. Bill Sample, R-Hot Springs, defeated a vocal opponent of the program. In Senate District 17, Rep. John Burris, R-Harrison, an architect of the program, will be in a runoff next month with Scott Flippo, who has denounced the private option.
In the House, private-option opponent Rep. Randy Alexander, R-Springdale, lost in the primary, while another program opponent, Rep. Jim Dotson, R-Bentonville, survived. A supporter, Rep. Sue Scott, R-Rogers, made it through her primary with a sizable victory. Rep. Fred Smith, a Crawfordsville Green Party member running as a Democrat, was unseated by another private-option supporter, Democratic House leaders said. Rep. John Hutchison, R-Harrisburg, who changed his vote on the private option from support in 2013 to opposition in 2014, lost by a wide margin Tuesday to a private-option critic, former Arkansas State Police Trooper Dwight Tosh.
Many of the winners in those races said the private option was not the main reason for their victory or the focus of their campaigns.
"I don't think that particular issue had an effect," said Republican Lance Eads, the Springdale Chamber of Commerce vice president who unseated Alexander. "My goal was to be somebody who was available and a little more open to listening to the entire district, and I think people responded to that."
Some of the legislative-race winners who face no opposition in the general election remain undecided about the private option.
Saline County Judge Lanny Fite, a Republican who was unopposed for the District 23 House seat, said it was too early to swear his allegiance either way.
"I think it would be rash on my part to make a decision at this point," he said. "I just don't think I can commit until I see the numbers and the costs from this year."
Rep. Jeremy Gillam, R-Judsonia, who is in line to be the next speaker of the House, said the incoming freshman class has others who share Fite's view.
"From what I've been able to tell, we're close to where we were before, but that's just looking at candidate surveys and interviews," Gillam said. "A lot of these new incoming members are taking a wait-and-see approach. I think we're hovering probably still around 75 votes. Their attitudes may change as they learn more and as some of the numbers come in."
Political science professors from around the state said they were sure the debate over the private option, which opponents said will cost the state too much money in the long run, had an impact on the elections, but they didn't want to overestimate the importance of the issue on Tuesday's outcome. They also didn't want to overstate the effect the election results will have on the program's future.
"We always knew the program was going to be in some trouble. It's always barely snuck through each house of the Legislature. And that hasn't changed with this election," said Jay Barth, a Hendrix College political science professor.
"In the Senate, if it really only loses by one vote with Terry Rice defeating Holland, that might be something that could be overcome. A Burris loss in the runoff would not be just an extra vote lost; it would be symbolic because of his role in designing the program. That's clearly where people will be looking. The situation in the House ... there wasn't a tidal wave in either direction, and every vote matters."
The expansion of the Medicaid program extended eligibility to adults with incomes of up to 138 percent of the poverty level: $16,105 for an individual, for instance, or $32,913 for a family of four.
Those who do not qualify for Medicaid but have incomes below 400 percent of the poverty level may qualify for tax-credit subsidies to help pay their premiums for plans offered on the exchange.
As of March 31, 155,567 applicants had been approved for coverage, but not all of them had enrolled.
The debate over funding the program almost caused a standstill in the House during the Legislature's fiscal session earlier this year, barely eking through by one vote in each chamber.
Metro on 05/22/2014