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LITTLE ROCK—An effort to continue the hybrid Arkansas Medicaid expansion another year failed Monday in the state Senate, days after Republican efforts to repeal and replace the federal health law that enabled the expanded coverage faltered in Congress.
The budget bill for the state's Medicaid program and the expansion failed on two votes—by a 19-1 and a 20-1 margin—falling short of the 27 needed to approve the budget measure. Legislative leaders said they planned to try again with the proposal on Tuesday, and were confident they had the votes needed.
The top Republican in the Senate said he didn't believe the program would be blocked while the future of the federal health law remains in limbo.
"I don't think there's sufficient will right now to start blocking budgets when we don't even know what's going to happen or how long it's going to take," Senate Majority Jim Hendren said after the votes. "We owe the state of Arkansas a budget and I think most people understand that."
More than 300,000 people are on Arkansas' hybrid program, which uses Medicaid funds to purchase private insurance for low-income residents. The program was crafted in 2013 and has sharply divided Republicans since then in the Legislature, who have repeatedly derided the federal health care law. GOP Gov. Asa Hutchinson effectively saved the first-in-the-nation program last year after it failed to get enough votes by voiding part of a budget bill that would have ended the expanded coverage.
Hutchinson earlier this month said he would seek federal approval to move 60,000 people off the expanded coverage and on to the insurance marketplace, and to impose work requirements on able-bodied participants. The governor plans to call a special session next month to take up legislation related to those changes.
Republican Sen. Bryan King, the only lawmaker to vote against the budget bill both times it came up Monday, said the program's funding should be considered alongside those changes in the special session. The total cost of the expansion in the coming fiscal year is estimated to be $1.8 billion, with the state paying $109 million and the federal government paying the rest.
"You don't need to give people a credit card to spend whatever they want to without knowing the details first," King said Monday night.

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