Arkansas’ private option will probably be settled one way or the other next week. A bill funding the Medicaid expansion plan for its second year, SB111 passed the Arkansas Senate on Thursday, and a vote of 75 of the Arkansas House’s 100 members would continue to make the private option the law of the land.

The House voted for the fourth time today (Friday) on its identical bill to re-fund the private option, with 71 votes in favor. Another vote is expected on Tuesday — "It keeps happening," as one Capitol insider put it.

Rep. Stephen Meeks (R-Greenbrier) said on Friday, "I know it looks like we’re just doing the same thing over and over again, but I can assure everybody that there’s a lot going on behind the scenes,"

Meeks and his brother, Rep. David Meeks (R-Conway) have voted against a second round of funding for the private option. Both said on Friday that they were hoping for a compromise proposed last week to gain traction.

The compromise would keep the overall framework of the private option, which uses federal funds to subsidize private insurance for Arkansas’ poorer citizens, but add an annual open enrollment period.

Both brothers said that the open enrollment period would act as a "cap" on enrollment in the private option as well as cut down on the number of people who would enroll only once they became seriously ill, which would defeat the purpose of insurance.

"It would allow for better planning for the state and give us an opportunity to plan for it, and then we can come back and revisit it in 2015 — when who knows what will be happening in Washington — and see what’s happening with it then," Stephen Meeks said.

"We realize that the votes don’t exist to defund the private option," Stephen Meeks also said. "What we’re doing is trying to hold out to make the system the best possible system for Arkansans until we can delve into it next year. … I think the private option will pass in some form or another, but unless some compromise is reached, don’t expect me to be vote 75.

"The overwhelming majority of people who have contacted me have expressed their opposition to the private option, and most have been very gracious and courteous, but there have been a few hateful messages and emails. … The alternative, if we just continue to vote "no" is the Department of Human Services is going to shut down and we don’t want that either; even though I’m opposed to the private option I don’t want to take those close to 100,000 people and boot them off after they’ve made a good-faith decision to enroll in the private option."

David Meeks said that he’s seeing "a lot of folks who are working for compromise [and] reaching across the aisle."

He’s hoping that the compromise plan has a little more "traction" after "they see us holding our ground and them not getting the 75 votes that are necessary."

The fact that the private option passed in the Senate on Thursday and the votes in the House have been only a few Representatives shy of the mark means that the private option probably will survive, according to Rep. Steve Magie (D-Conway).

"Anything that takes a three-quarters majority is obviously going to be difficult to pass because there are going to be strong opinions, but the way I see it, when it gets this close, then people are beginning to coalesce together and beginning to really re-evaluate their positions," Magie said. "And I think it’ll pass, because people are beginning to have their constituents call them and tell them what a great benefit and what a wonderful thing this is for Arkansas."

Magie, an ophthalmologist, said that a patient in his office was able to get cataract corrective surgery only after she was enrolled in the private option plan, "and now this woman, whose visual acuity was that she would tell daylight from dark, is functioning, seeing her family for the first time in many, many years, reading and watching her favorite movies.

"We are not a third-world country, and there is a no reason why a person should be blind in this country from a correctable condition. When the human factor is included, and the fact that you’re helping people as much as you can is included, you can’t deny that this is a good thing."

Rep. Doug House (R-North Little Rock) has consistently voted for the private option, and put his reason why more succinctly:

"I still hate Obamacare, but those are the cards we’re dealt and I’m going to play them as best I can," House said.

State Sen. Jason Rapert (R-Conway) said that he voted for the private option despite what he said remains strong opposition to the federal Affordable Care Act.

"Arkansas and the entire nation is in chaos as a result of the federal health care reform, also known as Obamacare," Rapert said. "I have opposed it from its beginning and did everything I could to stop our state from spending either its money or grants until the Supreme Court [of the United States] rendered its decision."

Rapert said that despite an amicus curiae (literally: "friends of the court") brief that he joined outlining the legal case against the Affordable Care Act, "the Supreme Court did not agree, and the law became the law of the land."

Rapert said that he wouldn’t try to mislead his constituents by saying that he has the power, as a state senator, to bring down "Obamacare."

"The only effective way to repeal Obamacare is the 535 U.S. senators and congressmen to agree to repeal it and hopefully we’ll have a president then that will agree with them, and the nation can finally breath a sigh of relief and move on from this."

Until that day comes, Rapert said, he is convinced after meeting with Conway Regional Medical Center and Baptist Health officials, as well as those from local schools, universities, the Chamber of Commerce and others, that supporting the private option was the best choice for the short-term future of Arkansas.

"For now, I simply hope we have done something that will allow our state and our community to survive until we can repeal this at the federal level and come up with something that will work," he said.

Dr. Bart Throneberrry and Jim Lambert, board chairman and CEO of Conway Regional, respectively, wrote in a letter urging Rapert to support the private option that the independent hospital could expect to lose between $850,000 and $1.2 million were the private option to fail.

"The Medicare reimbursement cuts are here to stay," Rapert said. "And we can’t afford to see it mortally would our local hospital possibly, and definitely some other hospitals in the state."

(Staff writer Joe Lamb can be reached by email at joe.lamb@thecabin.net or by phone at 505-1277. To comment on this and other stories in the Log Cabin, log on to www.thecabin.net. Send us your news at www.thecabin.net/submit)