Our Reporter in the paper this week looks at three GOP state Senate primaries that could have an outsized impact on the future of the private option — the state’s privatized version of Medicaid expansion which has been the defining issue in intra-party Republican squabbles. Yesterday I added some outtakes from one of those races — between incumbent Sen. Bill Sample and retired financial auditor Jerry Neal. Today let’s take a look at some more from the race between Rep. John Burris, one of the co-sponsors of the private option, and Scott Flippo, owner of a Bull Shoals nursing home, who opposes the policy. Burris and Flippo are vying for an open senate seat vacated by Sen. Johnny Key, who voted for the private option (there is also a third candidate in the race, Mountain Home mayor David Osmon, who supports the private option; most expect Burris and Flippo to emerge from the race and face off in a runoff). 

As with all of these battles in GOP primaries, we get to hear the word “Obamacare” a lot. The private option uses funds made available by the national health care law. Flippo says that by voting for the private option, Burris implemented Obamacare in Arkansas; Burris argues that Obamacare was coming no matter what and that the private option represented a conservative reform in the best interests of the state. Here’s Burris in this week’s Reporter, where you can get more of the back-and-forth:


“You’ve got to start with what Obamacare took from us. You add up Medicare [reimbursement] cuts and tax increases, it’s $1.25 billion a year out of our economy. I couldn’t stop those things. I couldn’t stop the essential health mandates driving up the cost of your premiums. I couldn’t stop the individual mandate that’s penalizing people for not buying insurance they can’t afford. I tell people, call somebody you trust in another state [that said no to expansion] and ask them if they have Obamacare, too. They’re going to tell you yes.” The private option, Burris argued, was a way to bring money back to the state and use it “to reform our Medicaid system and our health care system … and get waivers [of federal rules] to put our fingerprint on the system.”

“I expected it to be an issue in the race,” Burris said. “I knew what I was walking in to.” 

Burris said that he strongly opposes Obamacare and that attacks on him suggesting that he brought Obamacare to Arkansas were misleading. “There’s a lot of things that Obamacare is that people don’t like,” Burris said. “They don’t like the taxes, they don’t like the Medicare [reimbursement] cuts, they don’t like the benefit levels that drive up the cost of their insurance. When you say ‘Obamacare,’ that is what people think of. I think it’s very cheap to say that I brought that to Arkansas. It’s misleading and it’s not accurate. I’m very comfortable with the debate on the private option. I think I’ll win it every time. I think they’re being dishonest with voters when they say, ‘He brought you Obamacare,’ when they know the things that voters are mad about aren’t the private option or the coverage, they’re mad about other things. And they’re giving the impression that [those other things] could have been avoided.” 


As for Flippo, he said, “I don’t see how the private option is going to curb our health care costs or to really solve long-term solutions to our problems. When I look at the projections they’re basing their numbers off of, in the private sector, in my business, I could no more go through a deal based on those soft projections than a man on the moon. One of my chief concerns is the long-term viability.” Flippo added: “I do feel that this is an expansion of Obamacare into Arkansas. My opponent and I disagree. He says that [the private option] is not per se Medicaid expansion. I believe that it is. Medicaid expansion is one of the pillars of Obamacare. When the Supreme Court ruled that the federal government couldn’t mandate that states expand Medicaid — I look at 24 states that decided not to do it, and I don’t think for a minute that all these hospitals are going to shut down.” 

I asked Flippo about the 150,000 (and counting) Arkansans who have gained coverage under the private option. “Had Arkansas not done it,” Flippo said, “everyone below 138 percent [of the federal poverty level] would have qualified for Medicaid, on the exchange, on Obama’s market.” This is not true, I explained, but it is true that if Arkansas had said no to expansion or repeals it in the future, a small subset of private option beneficiaries — people who make between 100-138 percent of FPL — would qualify for generous subsidies to buy insurance on the Arkansas Health Insurance Marketplace, the insurance exchange created by Obamacare. But people below the poverty line would not qualify for those subsidies. Flippo responded: “Correct, and [below] 100 is already on Medicaid.” Unfortunately, this is also incorrect — without the private option, adults without dependent children don’t qualify for Medicaid in Arkansas no matter how poor; parents only qualify if they make less than 17 percent FPL ($2,675 a year for a family of two, $4,054 a year for a family of four). That would leave a coverage gap for the state’s poorest citizens if the private option goes away.


Once that confusion was cleared up, Flippo said, “There’s a lot of needs in Arkansas. I don’t believe government’s going to be able to solve every problem that faces people. Let’s look at it – I’m somewhat familiar with Medicaid and Medicare. There’s a lot of waste within these current programs.” 

Both candidates said that the race was about more than the private option. Burris said that many of his supporters disagree with him on that issue. “I’ve got support from people that know me and appreciate the work that I’ve done and no amount of money from Conduit for Action can change that,” he said. 

“Certainly I think that voters are not just going to be looking at one thing,” Flippo said. “The private option would be the large issue. Is it going to be the only issue? No.” Flippo pointed to his opposition to Common Core standards and his opposition to changes to legislative term limits as major differences with Burris. 

Burris said that he was focusing on his overall record and experience. “I’ve been involved for a very long time,” he said. “And I’ve got a very long history, including things like tax reform, pro-life legislation, Voter ID, and helping elect other Republicans to office who can help enact those things. Scott Flippo has a history of doing nothing in terms of policy and politics. I think that’s something that differentiates us.” 


Burris said he did not think the outcome of the race would decide the future of the private option. “No, I don’t,” he said. “I think there’s a couple of people spending a lot of money hoping that it will. That’s why they’re spending tens of thousands of dollars to try to beat me. But at the end of the day, I believe in the legislative process. An issue’s bigger than one person. An issue is bigger than one organization.”

Flippo said, “there’s passions on both ends of [the private option]. Hopefully this is not going to be an issue that will divide us as Republicans or as Arkansans going forward. This is going to be one of those things, this is a large issue. Creating another government program, how is it going to solve our health care problems? These are core questions and core concerns for conservatives.”

Of the variety of mailers and ads going back and forth, Burris said he thought most people in the district “think it’s goofy…I get messages and e-mails on a daily basis from people I’ve known my whole life and they’re like, ‘hey man, I defended you at the diner. They say you implemented Obamacare and I know you didn’t.'”

The primary is this Tuesday.