Four years after Republicans commandeered Arkansas' Legislature by campaigning against the federal healthcare overhaul, similar attacks are being aimed inward in several GOP primaries that could play a role in determining whether thousands will remain covered under a key part of that law.
Tuesday's legislative primaries will be the first major test of Republican Gov. Asa Hutchinson's plan to keep the state's first-in-the-nation hybrid Medicaid expansion. Hutchinson and fellow Republicans who previously supported the expansion are coming under fire from rivals and conservative groups painting them as supporters of the law often derided as "Obamacare."
"It's a big government program that Republicans need to quit supporting," said state Rep. Donnie Copeland, who's hoping to unseat GOP Sen. Jane English in a North Little Rock district.
Crafted in 2013 as an alternative to expanding Medicaid, the "private option" uses federal funds to purchase private insurance for more than 200,000 low-income residents. Hutchinson has proposed renaming the program "Arkansas Works" and adding new restrictions on eligibility and benefits.
Tuesday's results won't change the makeup of the Legislature when it meets in April to take up the proposed changes. But it complicates Hutchinson's efforts to keep the plan alive.
"If we do not work to get the truth out to the Arkansas voters, then yes, we're not going to make that three-fourths margin because legislators listen to the voters," Hutchinson said earlier this month, referring to the votes needed in the Legislature to reauthorize the program.
The intraparty fights include three GOP Senate primaries. Republican Sen. Eddie Joe Williams is fending off a primary challenge for his central Arkansas seat from R.D. Hopper, who has vowed to oppose the expansion. State Rep. Lance Eads is running for a northwest Arkansas Senate seat against Washington County Justice of the Peace Sharon Lloyd, who also says she'll vote against the plan.
Medicaid expansion foes have enlisted the help of conservative groups including Conduit for Commerce and Americans for Prosperity, which have been targeting lawmakers over their past support.
English voted against the program when it was crafted, but backed its reauthorization in 2014 after she negotiated changes to the state's workforce training program with then-Gov. Mike Beebe, a Democrat. She also voted for the program's second reauthorization, along with the creation of a task force to come up with a replacement for the hybrid expansion.
Copeland regularly hammers English over the vote, with one mailer saying she "sold us out and voted 'yes' on Obamacare Medicaid expansion." English has called the attacks misleading and describes the challenge as an attempt by outside groups to influence her district.
English, who says she hasn't decided whether to support Hutchinson's revised expansion plan, doesn't regret her past votes.
"I have to do what I think is right and what I think is right for the people of the district," she said.
Other lawmakers being challenged over their private option votes include two Republican House members in northwest Arkansas: Reps. Jana Della Rosa and Sue Scott.
The outside groups also are rallying support in the Legislature against Hutchinson's plan.
"This is a distinction without a difference, and Arkansas legislators should reject any attempts to cement Arkansas's status as an Obamacare Medicaid expansion state," David Ray, Americans for Prosperity's state director, said earlier this month.
Hutchinson has defended his plan and the lawmakers being challenged over their past votes in favor of the expanded coverage, rejecting the criticism that it amounts to an embrace of the health law they've opposed. He's also warned that dropping the expanded coverage would create a $100 million deficit in the state's budget.
Williams, who says he hasn't decided whether to back the proposal, said his past votes were about reclaiming money that Arkansas was losing to Medicare cuts and taxes included in the overhaul.
"That's Arkansas' dollars, that's money that was taken out of our economy," he said.