The effort to keep Arkansas' Medicaid expansion another year faced uncertainty on Tuesday, with the program falling short of the votes needed for its reauthorization in the state Legislature.
The House voted 53-31 for the budget bill for Medicaid and the expansion program, falling short of the 75 votes needed for its reauthorization. Another vote was scheduled Wednesday on the legislation, which has already been approved by the Senate.
Arkansas' Medicaid expansion has sharply divided Republicans, who control a majority of the Legislature, since it was first approved in 2013. Past efforts to reauthorize the program have faced repeated votes before winning narrow approval.
The bill failed after the House rejected a proposal to consider the expansion budget separately from the Medicaid budget.
Lawmakers last month approved a plan to overhaul the expansion program to encourage participants to work after a work requirement was blocked by the courts and President Joe Biden's administration. That overhaul must be approved by the federal government.