the red tide of the 2014 election swept over Arkansas as it did over the rest
of the nation. The “private option” was in political danger. Republicans
increased their majorities in both houses of the legislature, as many of the
new members pledged to overturn what they called the Obamacare-tainted
program.66 Governor Beebe, the Democrat who initiated the program, was
term-limited and left office in January 2015. He was replaced by Asa
Hutchinson, an experienced and politically savvy Republican.67
The politics of preserving the essential features of the “private option”
are intricate. As explained above, state funding for the program must be
renewed annually by a three-quarters supermajority vote of both houses of
the General Assembly.68 During the gubernatorial campaign, candidate
Hutchinson cannily refused to take a position on the merits of the “private
option,” not wanting to alienate his conservative, anti-Obama base.69 But
Hutchinson was fully aware that the state’s hospitals had come to depend
on the payments from more than 200,000 newly enrolled and insured
Arkansas residents—individuals whose emergency room visit costs the
hospitals were previously required to absorb. The county seats and other
rural towns depend on their hospitals as essential features of community
life. Even Republican Tea Party legislators must listen to local hospital
Additionally, candidate Hutchinson had pledged a $100 million cut in
state income taxes.70 But without the federal funds supporting the Medicaid
expansion, the Hutchinson Administration would be unable to afford the
promised tax cuts and still keep the budget balanced as state law requires,
without snatching away health insurance newly made available to many
thousands of voters—a politically unacceptable risk.
In the end, Governor Hutchinson deftly crafted a solution that
satisfied—for the time being—both the anti-Obamacare Republicans and
the Democrats supporting the Medicaid expansion. Drafted by the Governor
66. See, e.g., John Lyon, Private Option Expected to Continue in Altered Form – If at
All, ARK. NEWS (Nov. 9, 2014), http://arkansasnews.com/news/arkansas/private-option-expected-continue-altered-form-if-all.
67. Hutchinson, incidentally, as a Congressman in the 1990s, managed the
impeachment proceedings against fellow Arkansan Bill Clinton. John King, House
Managers Argue for Clinton’s Impeachment Conviction, CNN (Jan. 14, 1999),
68. See sources cited, supra note 30.
69. See Andy Davis, Governor Airs Health Plan, ARK. DEMOCRAT-GAZETTE, Jan. 23,
2015, at 1A, 2A (noting that Gov. Hutchinson had not previously said whether he supported
continued funding for the private option); Brenda Blagg, The Deal Isn’t Done, ARK.
DEMOCRAT-GAZETTE, Jan. 25, 2014, at 2H (opinion column) (same).
70. Roby Brock, Hutchinson Outlines Plan to Cut Income Tax Rate, THECITYWIRE.COM
(Nov. 12, 2013), http://www.thecitywire.com/node/30464#.VPO2L_nF92Q.