The votes of Clark and Rice for the appropriation were a surprise because they are opponents of the state’s version of Medicaid expansion, which covers about 285,000 low-income Arkansans.

the same day as the primary election. The other vacant seat, formerly held by Sen. Jake Files, R-Fort Smith, will be filled in an Aug. 14 special election.

Monday, a federal official announced approval of a work, training or volunteerism requirement for some Arkansas Works enrollees.

“The work requirement was huge in getting me to the point that I could say … somebody needs to make this vote to keep us from having to keep the state in suspense for two months, ” Clark told reporters. “If I had the clout to really change this program, I would still be a ‘no’ and I’d fight it out …

“[But] it doesn’t mean that next year that this battle won’t take place and I won’t have the votes to actually really make some major changes in this policy. I am not like the people in the past who have suddenly converted, because I have not converted,” Clark said.

Rice said he voted for the appropriation because the Senate more than likely would have reached the 27 votes required for approval after the May 22 special elections. He also said he doesn’t want to have people worry about the possible shutdown of the department.

“I hate to have a last-minute crisis every time,” Rice said.

He said the federal government’s approval of the work requirement was a factor in his decision for the appropriation.

Nonetheless, Rice said he doesn’t believe the Medicaid expansion program is financially sustainable over the long term and he wants to work on developing changes in advance of the 2019 regular session.

Sen. Linda Collins-Smith, R-Pocahontas, and King, who voted against SB30, told senators that Medicaid expansion is too expensive for the state.

Sen. Missy Irvin, R-Mountain View, told her colleagues that she was voting for the appropriation for the children who are on Medicaid and “those are people you and I serve.”

Sen. Larry Teague, D-Nashville, told senators said, “This is about helping about 300,000 people.”

In 2017, the Division of

Medical Services appropriation cleared the Senate in a 27-to-1 vote. It failed twice before it was approved. Williams and Files voted for the measure, while Standridge, who supported the Medicaid expansion program, didn’t vote on it, according to the General Assembly’s website.

In 2013, the Republican-dominated Legislature and then-Gov. Mike Beebe authorized the creation of the Medicaid expansion under which the state purchases private health insurance for some low-income Arkansans. It was initially called the private option and is now called Arkansas Works after changes in the program under Hutchinson.

The Medicaid expansion program has operated under waivers granted by the federal government under the federal Patient Protection and Affordable Care Act. The federal law was signed into law by then-President Barack Obama in 2010.

Nineteen Republicans and eight Democrats voted for SB30, while two Republicans voted against it. Two Republicans didn’t vote and a Democrat voted present on the measure. One of the Republicans who didn’t vote on the measure is Sen. Scott Flippo of Mountain Home, who defeated then-state Rep. John Burris of Harrison, one of three legislative architects of the Medicaid expansion, in a special election in 2014.

The $8.2 billion in spending authority granted to the Division of Medical Services under the measure includes federal revenue of $5.7 billion, state general revenue of $1.2 billion, $468 million in other revenue and $766 million in unfunded appropriations, said state Department of Human Services spokesman Amy Webb.

Webb said the total number of people on the state’s Medicaid program wasn’t immediately available on Wednesday afternoon.

Hutchinson said Tuesday, “I’m very grateful for the senators that were able to support Arkansas Works and the DHS appropriation.

“Obviously the work requirement was a significant factor in showing the reform that we’re accomplishing, and I appreciate the Senate’s leadership in passing this on the first vote,” the governor said in a written statement.