The Arkansas House has voted four times this week on a bill to renew the state's Medicaid expansion program, and it's not done yet.
The legislation failed to reach the needed supermajority in the House for the fourth time on Friday. The 71-18 vote came up four short of the needed three-quarters threshold to pass spending bills in the Legislature.
At question is the Arkansas "private option," which takes federal funds for Medicaid expansion under the Affordable Care Act and applies them to private exchange plans for low-income individuals.
The Senate passed the bill Thursday on a 27-8 vote.
If the legislation fails, the nearly 100,000 Arkansans who have already enrolled in the program will lose their coverage after June 30.
The funding for the private option is part of the larger appropriations bill for the state's Human Services Department, so the broader package ultimately has to pass at some point. But it could pass without funding for the Medicaid plan, and that funding will be left behind if one faction of state Republicans get their way.
Lawmakers on both sides remain confident that the private-option funding will be renewed eventually, according to the Arkansas Times. But not before a series of failed votes and a heavy dose of legislative drama.
The margin of approval to renew the private option is so razor-thin that members were scrambling to find the necessary votes even as the speeches went on. The House recessed several times Thursday afternoon as negotiations continued.
At one point, state police were sent to fetch a representative who left the floor ahead of the vote.
Republican House Speaker Davy Carter has said lawmakers will continue voting until the bill is passed. A fifth vote is scheduled for Tuesday afternoon.