LITTLE ROCK, Ark., May 19 (Reuters) - As voters head into primaries on Tuesday in the southern swing state of Arkansas, one of the most fiercely debated issues among Republican candidates is the centerpiece healthcare policy of U.S. President Barack Obama, a Democrat.
A group of Arkansas Republicans are battling for their political lives in primary showdowns with challengers from their own party who are trying to excoriate them for reaching a compromise with Democrats on a state health plan. This plan, aimed at the poor, is called the "Private Option" and meant to be an alternate to the Affordable Care Act, or "Obamacare".
"It's the hot button," said Republican state Senator David Sanders of Little Rock.
At stake is how far the Republican party will swing to the right in a state where they hold a narrow majority in the House of Representatives. Even Democrats often position themselves as conservative centrists.
Republican challengers in state legislative races are targeting incumbent GOP lawmakers who supported their party's leadership and approved the Private Option.
The issue has created far fewer ripples in Democratic races.
The Tuesday primary is for Democrats and Republicans with voters casting ballots for candidates to represent the parties for local posts, the statehouse and U.S. Congress in elections in November.
The program being hotly debated uses federal Medicaid funds from the Affordable Care Act to help buy health insurance for low-income Arkansas residents, many of whom would otherwise be assigned to Medicaid or have treatment costs absorbed by doctors and other healthcare providers.
"That's all they're making it about, the Private Option," Sanders said of the Republican challengers.
Variations on the Arkansas model have since been adopted or are under consideration in other states including Republican strongholds such as Utah, and battlegound states in presidential elections including Pennsylvania, Michigan and Ohio.
Opponents in the Arkansas General Assembly said both the Private Option and the Affordable Care Act are too costly and represent an unacceptable expansion of government.
The future of the Private Option could also be determined on Tuesday. The Arkansas Senate approved funding for the program this year by a single vote, and three Republican senators who supported it are facing primary opponents.
Obamacare will be hanging over one of the state's marquis races in the general election in November where incumbent U.S. Senator Mark Pryor, a Democrat, has been straining to maintain a lead in the polls over the Republican challenger, U.S. Rep. Tom Cotton, who is supported by the Tea Party.
Pryor and Cotton face no serious threats in the primaries.
Pryor, who is seeking a third six-year term, voted for the Affordable Care Act. Cotton is a harsh critic of the program.
Health care reform also could be a decisive issue in races for two open U.S. House seats in Arkansas now held by Republicans - Cotton, and U.S. Rep. Tim Griffin, who is leaving Congress after two terms. (Reporting by Steve Barnes; Writing by Jon Herskovitz; Editing by Scott Malone and Diane Craft)