RALEIGH — After an intense three-month campaign for the votes of North Carolina's House members, players in the health care debate including business, labor and the administration are now likely to focus their full attention on Sen. Kay Hagan.
Hagan, a moderate, pro-business Democrat, is regarded as one of a handful of senators who could play a pivotal role in the coming weeks as the Senate takes up the landmark legislation to expand access to health insurance. Although Hagan supports passage of a health care bill, she has suggested a willingness to compromise.
A health care bill passed the House narrowly Saturday. Now the Obama administration faces an even tougher fight in the Senate. Majority Leader Harry Reid must keep his bloc of 60 votes united for a bill to pass. That gives individual senators significant leverage in shaping the legislation and makes their loyalties a prize.
"There is enormous pressure on Senator Hagan," said Adam Searing, a health care expert at the N.C. Justice Center, a Raleigh-based group pushing for broader health care coverage.
Hagan has already been the subject of television commercials by the pharmaceutical industry, two mailers by Blue Cross Blue Shield of North Carolina and hundreds of pickets at her Raleigh district office.
On Monday, Hagan reiterated her support for the plan passed this year by the Senate Health Committee on which she serves. But she has previously said she remains flexible on key details such as a public option, providing herself with negotiating room in the coming weeks.
"We need health reform in this country," Hagan said Monday in recorded message to North Carolina reporters.
"I want to be sure if people have a pre-existing condition they can have access to health insurance," Hagan said in the message. "I want to be sure it is affordable and accessible."
Hagan said the average North Carolina family's annual health premium has doubled from $6,000 to $12,000 in the past decade, and is projected to rise to $24,000 in 2017 if something is not done.
Brad Crone, a political consultant who represents a consortium of major health care companies, said Hagan is getting lobbied hard from all sides.
"The spotlight is going to get brighter," Crone said. "The positive side for Hagan is she has done a good job of reaching out to all parties and being open and receptive."
3 N.C. 'defectors'
Before last weekend, when the House voted 220-215 to pass a health care proposal, the pressure now building on Hagan was felt by moderate House Democrats.
Three Tar Heel House Democrats defected from the leadership and voted against the Democrats' plan to overhaul health care. No state in the country had more Democratic defections, although several states had as many.
The bloc of no votes underscored why both supporters and opponents targeted North Carolina for a major lobbying campaign, including a visit to Raleigh by President Barack Obama, extensive grass-roots organizing by both sides, and major TV advertising campaigns.
North Carolina's delegation in the House voted 8-5 against the health care bill. Democrats Mike McIntyre of Lumberton, Heath Shuler of Bryson City and Larry Kissell of Biscoe joined the delegation's five Republicans in opposing the measure.
McIntyre and Shuler had been expected to oppose the legislation. Both are considered Blue-Dog Democrats who represent conservative-leaning districts that voted for Republican John McCain in the last presidential election.
Kissell, a freshman who unseated Republican Robin Hayes last November, had been elected with the help of many party liberals.
Ralph Bostic, chairman of the Montgomery County Democratic Party, said he was shocked by the vote.
"I am very upset about him voting the way he did," Bostic said. "I think it was a sellout."
Vancine Sturdivant, Anson County Democratic chairwoman, noted that Obama carried Kissell's congressional district.
"It's not acceptable at all," Sturdivant said.
Kissell could not be reached for comment Monday. He had previously cited his concern that Medicare, the government-run health care program for the elderly, could be harmed by the reform.
Ads exert pressure
Rep. Bob Etheridge of Lillington, a moderate Democrat, voted to support the health care bill. Etheridge was pressured over the weekend by TV ads paid for by the U.S. Chamber of Commerce. The Chamber spent $92,246 in ads pressuring Etheridge on WRAL-TV in Raleigh alone.
Etheridge has been weighing a possible challenge to Republican Sen. Richard Burr next year. Etheridge had also landed a coveted seat on the House Ways and Means Committee, and it would have been tough for him to buck the House leadership.
Dallas Woodhouse of Americans for Prosperity, which organized a statewide bus tour against the Democratic health care proposal, said there could be political blow-back against Etheridge in the next election.
"Congressman Etheridge portrays himself as a pretty conservative Democrat back home," Woodhouse said. "But most conservative Democrats voted against it. It is certainly a vote he will have to own." Etheridge could not be reached for comment Monday.
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