On Tuesday, the Attorney General approved a ballot title that would place before voters the opportunity to repeal the Medicaid Private Option. If it makes it to the 2014 ballot, it will cause numerous political headaches for Arkansas Republicans.

As you recall, Republican legislative leaders crafted the Medicaid private option, which implements a major portion of Obamacare by insuring low-income Arkansans and saves the state hundreds of millions of dollars. By passing the private option, many legislative Republicans are dealing with blowback from the folks on the right back home who believe they voted to implement Obamacare, which of course they did, but Republican legislators just don’t like it put that way.

The Tea Party organization known as Arkansans Against Big Government is behind the repeal private option idea and they don’t care about saving taxpayers’ money or helping the “least of these” that live among us.

They are also going to cause Republican leaders some major headaches.

Responsible legislative Republicans leaders know that repealing the private option would be a financial and political disaster. The problem for Republicans is they’ll have to convince members of their own party to keep a portion of Obamacare intact, which creates a messaging problem, and makes their base unhappy.

How do Republican leaders convince voters that supporting Democrats means supporting Obamacare (which isn’t true, btw) while at the same time asking them to vote to support a major portion of Obamacare? Moreover, they’ll be fighting with members of their own party, not a fun position to be in come election time.

If the voters fail to support keeping the private option, it has the potential to create major havoc in the 2015 legislative session. A school of thought believes repealing the private option means state government will lose tens of millions, if not hundreds of millions of dollars, which means budget cuts or tax increases. Neither are enjoyable options.

If Republicans retain control of the State Legislature and also win the Governor’s Mansion they will take the blame for cutting millions from the state government budget. Their problem would be compounded by the fact that the tax cuts favoring the wealthy they passed will make budget cuts even deeper. The tax cuts were originally made possible without budget cuts due to the savings afforded by implementing the private option.

Many of these potential budget cuts will be directly felt by Arkansans. Who will they blame for harmful budget cuts? Republicans.

The flip-side is if Democrats win the House and/or the Governor’s Mansion they will make the tough decisions, but from a message perspective they can point out that it was Republicans who were the cause of the budgets cuts by fighting to repeal the private option and them giving tax cuts to rich folks.

Republicans are going to be in a political bind if this issue is on the November 2014 ballot. Will the Republic Party of Arkansas take a stand on this issue or just offer up a mealy-mouth, “whatever the voters decide” position?

One other note: a big selling point in support of the private option was the fact that without it – by doing nothing – there would be about $35 million in penalties levied on businesses in Arkansas. Undoing the private option kicks those business penalties back in.

Finally, how heartless is the AABG to fight to literally take away health care from low-income Arkansans who desperately need it? What is their plan to be their brother’s keeper and make sure everyone has access to affordable health care?

Actually, they don’t have a plan and just don’t care about those in need. And if stopping Obamacare means royally shafting 200,000 Arkansans, these heartless folks will do it with a smile on their face and a song in their heart.

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Michael Cook is the moderator for his opinion blog, Cook's Outlook. He can be reached by e-mail at Michael@CooksOutlook.com. Follow him on Twitter: @mcookAR or on Facebook: facebook.com/CooksOutlook.