The problem is: Under Arkansas law, the state legislature must vote again this year to accept federal funding for the expansion next year. Expanding Medicaid for 2014 required a 75-percent majority in each chamber, and accepting the 2015 funding does, too. The federal government covers 100 percent of the costs in the first three years and never less than 90 percent after that.

The expansion plan passed the 35-member Senate with one spare vote last year, but one Democratic state senator who voted in favor of expansion resigned last August amid a campaign scandal -- and an anti-expansion conservative, John Cooper, took his place last month after a special election.

Another Senate Republican, Missy Irvin, who voted in favor of expansion last year, has now said publicly that she will not support the funding for it this year.

....

Rep. Nate Bell, another Republican who opposes the private option, told the Times there was "no question" that conservatives had enough votes to block funding for expansion. "I think anybody in the Capitol building would agree with that," he said.

If that came to pass, more than 85,000 Arkansans who have signed up for coverage through the Medicaid expansion would presumably have that coverage stopped in 2015. Arkansas's alternative Medicaid plan uses Medicaid dollars to pay for low-income residents to purchase private coverage through HealthCare.gov. A select few, those making between 100 and 138 percent of the federal poverty level, would qualify for tax credits to purchase new coverage through HealthCare.gov. But the poorest of them, those below the poverty level, would be left without insurance.

TPM