Caveat as always: no Republican lawmaker has endorsed the new "private option" framework for Medicaid expansion. But many are speaking, writing and tweeting about it positively. Earlier this week Rep. Charlie Collins sounded downright excited about the new framework (maybe partly because of all the revenue expansion brings in). And to the far right end of the spectrum, Rep. Nate Bell offered this on Facebook:
It's important to understand that federal health care spending in Arkansas will dramatically increase under the PPACA even if Arkansas refuses Medicaid expansion. People between 100-138% of FPL will be receive a large premium subsidy to purchase insurance on the health insurance exchanges. It appears to be possible to reform our existing programs in such a way that the same net dollars can provide higher quality coverage to even more people and put our state Medicaid program on a sustainable path. Lots of numbers and data are being compiled and will be released this week. The bottom line has yet to be seen but a REAL conservative solution is possible. There's no way for the state legislature to prevent most of the dramatic increase in mandated federal expenditures but we can do our best to make sure that every dollar spent is used as judiciously as possible.
That's certainly not all the way to a YES, but that's a very open tone from one of the most conservative legislators in the state. And it presents the kind of even-though-we-hate-Obamacare argument, with a focus on the costs of doing nothing, that is going to be necessary to convince wobbly Republicans.
Meanwhile, Sen. David Sanders and Rep. Randy Alexander spoke on Tuesday to a Conservative Caucus group largely made up of skeptical Tea Party members. The Republican lawmakers acknowledged to the group that the "private option" didn't represent a true free market, but again made the case that doing nothing had its own problems from a conservative perspective — and suggested that the new framework might open up possibilities for further changes to the existing system.
Finally, we've seen Republican leaders in the House and Senate take to Twitter to speak in positive terms about the new framework:
Numbers are in: Private option best healthcare scenario for AR budget. Not so good for Feds who caused problem in the 1st place #arkleg— Bruce Westerman (@bruce_westerman) March 28, 2013
@nhhorton if we do nothing there is a lot of expense and government growth.Myth is nothing is a conservative option.— Michael Lamoureux (@Sen_Lamoureux) March 28, 2013
There is plenty of room for needed head-slapping about the comments above given where we've been and where we are. But it's the conservatives who will ultimately decide whether more than 200,000 low-income Arkansans gain health coverage or not. For proponents of expansion seeking to read the tea leaves, the examples above look like good news.