and his allies and sponsored by many of the previous Republican opponents
of the “private option,”71 the Arkansas Health Care Reform Act of 2015
passed both the Senate and the House by overwhelming margins,72 and
Hutchinson signed it into law in February 2015.73 The existing “private
option” program is to be extended, but only for two years until 2017, when
the 100% federal funding would decline to 95% and the state would need to
contribute taxpayer funds.74 Then the “private option” would vanish (as it
would have anyway, even absent this law),75 to be replaced by a broadly
reformed Medicaid program, whose dimensions and features would be
recommended by a task force composed of legislative leaders and the newly
appointed state Surgeon General, Dr. Greg Bledsoe, son of a key
Republican state senator.76 This reformed state Medicaid program could in
71. See Michael R. Wickline & Spencer Willems, Private-Option Plan Appeases Many
in Legislature, N. W. ARK. DEMOCRAT-GAZETTE, Jan. 23, 2015, at 2A (quoting four
Republican legislators who opposed the private option in the past but support Gov.
72. See John Lyon, Funding for Private Option, Governor’s Tax Cut Win Final
Passage, ARK. NEWS (Feb. 5, 2015), http://arkansasnews.com/news/arkansas/funding-private-option-governor-s-tax-cut-win-final-passage (reporting passage of Senate Bills 96
and 101 by votes of 27-7 and 29-2 respectively in the Senate and of 80-16 and 82-16 in the
73. 2015 Ark. Acts 46; see Michael Wilkey, Hutchinson Signs Private Option Bill, New
Tax Cut Bill Proposed (Feb. 9, 2015), available at http://www.thecitywire.com/node/
36408#.VPjkrPzF92Q (last visited April 18, 2015).
74. The time-limited framing of the Hutchinson proposal helped persuade some
skeptical Republicans. See, e.g., Wickline & Willems, supra note 71 (statement of Rep.
75. The new law’s extinguishing of the “private option” allows legislators who
campaigned on their opposition to it to proclaim victory. However, that provision of the new
law in fact has no practical effect. Demonstration projects such as Arkansas’s must end no
later than December 31, 2016. Watson, What Is at Stake in Arkansas?, supra note 7, at 489;
CTRS. FOR MEDICARE & MEDICAID SERVS., MEDICAID AND THE AFFORDABLE CARE ACT:
PREMIUM ASSISTANCE 2 (2013), available at http://www.medicaid.gov/Federal-Policy-
76. See Michael R. Wickline & Claudia Lauer, Senate Backs Private Option until 2017,
ARK. DEMOCRAT-GAZETTE, Jan. 30, 2015, at 1A, 6A (naming task force members); Spencer
Willems, Gov.-Elect Picks Senator’s Son as Surgeon General, ARK. DEMOCRAT-GAZETTE,
Dec. 31, 2014, at 1B (Bledsoe appointment). Senator Cecile Bledsoe had opposed the
“private option” bill in 2013, see Uninsureds’ Costs Plunge, supra note 60, at 7A. But in
2015, after her son’s appointment, she supported Senate Bill 96, Gov. Hutchinson’s two-year
extension of the private option. See http://www.arkleg.state.ar.us/assembly/
2015/2015R/Pages/ votes.aspx?rcsnum=44&votechamber=Senate (roll call vote).
Broadening the scope of public participation in the run-up to the program’s reform, Gov.
Hutchinson also appointed a Governor’s Advisory Council on Medicaid Reform, chaired by
Surgeon General Bledsoe. That council is to advise the legislative task force. Andy Davis,
Explore Options, Medicaid Panel Told, ARK. DEMOCRAT-GAZETTE, May 1, 2015, at 1B, 3B
[hereinafter Explore Options].