LITTLE ROCK, Ark. — President Barack Obama's health care overhaul has never been popular in Arkansas, a state where even most Democrats regard the law as politically toxic.
But with a quarter of the state's working-age population uninsured, a governor who once said he would have voted against the law now wants to use it to widen government-funded coverage to thousands of additional families. And he's relying on the move to help prevent a Republican takeover of the state Legislature for the first time since Reconstruction.
Gov. Mike Beebe, the first Southern governor to back the law's expansion of Medicaid, has become an unlikely advocate for a central part of the overhaul that would expand Medicaid, a position made easier by the fact that he's not seeking re-election.
“I think it's good for our people because it's helping folks that don't have insurance now that are working their tails off,” said Beebe, who is barred by term limits from running again. “They're not sitting on a couch somewhere asking for something.”
Two years ago, as the health care debate raged in Washington, Beebe said he wanted the president to focus more on the economy and even declared that he would not have voted for the bill if he were in Congress.
But it passed, and federal officials assured Beebe that the state could drop the expanded Medicaid coverage later if it wanted to. That's when the governor announced his support.
Beebe and other Arkansas Democrats are counting on voters to feel the same way. They say the benefits of a government program that helps so much of the state's population should outweigh any animosity toward the president.
If approved, the expansion would offer coverage to everyone making up to 138 percent of the federal poverty level. That works out to about $15,400 for an individual or $30,650 for a family of four. Most of those who would be added to the Medicaid rolls are low-income adults without children.
Debbie Willhite, a Little Rock Democratic consultant, said it's a “no-brainer” for legislative candidates to run on the expansion.
“We are a very poor state, and nobody needs to be told that. We have an incredible population that is underserved by health care,” Willhite said. “Anything that expands that is going to help individuals and help the economy.”
Under the law, the federal government agreed to pay the full tab for the Medicaid expansion when it begins in 2014. After three years, states must pay a gradually increasing share that tops out at 10 percent of the cost.
When it upheld the health care law back in June, the Supreme Court said the federal government could not take away states' existing federal Medicaid dollars if they refused to widen eligibility.
The expansion still faces a tough road in Arkansas. Approval will require a three-fourths vote in both the state House and Senate, a number that would be difficult to reach even with the current Democratic majorities.
Beebe has said he thinks lawmakers will support expanding eligibility when they see the broad benefits. The state Department of Human Services has estimated expanding the state's Medicaid rolls by 250,000 people will save the state $372 million over the next several years. Republicans have expressed skepticism about that figure, noting that it factors in savings from other parts of the federal health overhaul.
Republicans have questioned whether the state — which is expected to have a shortfall of up to $400 million in its Medicaid program next year — can afford the additional cost of expanded Medicaid coverage when the state begins to pay more.
“How can you put 250,000 people on a program and then turn around and kick them off?” said Rep. Bruce Westerman, the top Republican in the state House. “In reality, that doesn't happen with government programs.”
The GOP is using Beebe's support of the expansion to link the popular governor to Obama. One release issued by the state party after the governor's announcement was headlined: “The Beebe Agenda: Implement Obamacare.”
“It's clear Gov. Beebe's agenda is to implement Obamacare and stick the state with a bill we can't afford when he skips out of office in two years,” Arkansas Republican Party spokeswoman Katherine Vasilos said in the statement.
It's a familiar criticism for a party that saw its ranks in the state Legislature thinned in a 2010 election that hinged primarily on the president's unpopularity. Now Democrats are trying desperately to maintain their majority, which the party has successfully defended since this former Confederate state emerged from the aftermath of the Civil War.
After losing Arkansas by 20 percentage points in the 2008 election, Obama's approval rating here remains low. U.S. Sen. Blanche Lincoln, a two-term Democrat, lost her bid for another term in a race that focused primarily on her support for the health overhaul.
One of the few Democrats to survive the 2010 GOP surge was Beebe, who easily won re-election. With the popular governor backing the expansion, Democrats in the state say it's a chance to separate the policy discussion from the national debate over the health law.
“I think the public is smarter than some people give them credit for,” said Democratic Rep. Johnnie Roebuck, the majority leader in the Arkansas House. “I represent a very rural area. We understand this expansion is going to help our rural hospitals. We also understand it's going to help our rural people and our doctors.”
Beebe and other supporters also frame it as a way for Arkansas to get a return on its federal tax dollars, a view that the governor has promoted in his advocacy of the Medicaid expansion.
“If you and I and 3 million Arkansans are going to help pay for it through our tax dollars, I'm not going to sit on the sideline and tell New York they can have Arkansas' share,” Beebe told Democrats last month at the party's annual Jefferson-Jackson fundraiser. “As a matter of fact, if they want to give theirs up, I'll take theirs, too.”
Other Democrats in the state are embracing Beebe's stance on Medicaid, including those looking beyond the November election. Attorney General Dustin McDaniel, a Democrat and the only announced candidate for the 2014 governor's race, endorsed the expansion and said he hoped it wouldn't get blocked in a partisan debate next year.
McDaniel said he hopes the Legislature looks at the issue “in terms of what do we get, what's our risk, how much might it cost later as compared to a purely partisan” battle.
“If the discussion is dollars and cents and what's right and wrong,” he said, “the Legislature will make the right decision.”