3 NC Democrats running for Senate, 3 different positions on Medicare for All
Democrats consider health care the top issue for their vote, and the party’s large field of presidential contenders has spent considerable time debating the details of their plans — be it Medicare For All, a public option or gradual improvements to the Affordable Care Act.
The candidates fighting for the Democratic nomination for U.S. Senate in North Carolina have their own ideas on how to improve the access to and affordability of health care.
State Sen. Erica Smith, former state senator and Army veteran Cal Cunningham and Mecklenburg County Commissioner Trevor Fuller are all looking to take on Republican Sen. Thom Tillis in a race that could decide control of the Senate.
Retired Air Force Lt. Col. Atul Goel of Raleigh and Steven Swenson of Bunnlevel have filed to run in the primary as well.
“I kind of see them as not mutually exclusive,” Fuller said of the Affordable Care Act and Medicare for All. “The ACA was just a first step. It was never intended to be the only thing we would do. We’re stretching toward getting everybody covered. That’s got to be our North Star.
“If it takes five years to get there, OK. But our goal can’t just be incremental change. I think that’s not consistent with the times. We’ve got to be bold.”
At a forum earlier this year, Fuller said he was “unashamed” about his support for Medicare For All, calling health care a right for all and saying he thought it was the answer. Fuller said he did not think the government ought to take people’s insurance away if they want to keep it.
Fuller said Medicare For All is probably the closest to the right plan, but said it is unlikely to match exactly what presidential contenders Bernie Sanders and Elizabeth Warren have proposed.
“That’s the direction we ought to be heading in,” he said.
Smith, who said in an interview with WFAE that she doesn’t fall “solely on either side” of the debate, said she wants to improve the Affordable Care Act. Earlier this year, at the forum with Fuller, Smith said if Medicare For All “were the only option presented, I would not vote against it.” But she called the Affordable Care Act “a great plan.”
“My preferred plan is to take the Affordable Care Act and improve it and also try to transition to Medicare for all of who want it,” Smith said in a Nov. 22 interview with McClatchy. “I will work hard so every American will have access to as good health care as I would have as a U.S. senator.”
She said she favors lowering the age of those eligible for Medicare to 50 years old.
Smith said she supports prescription drug price controls. She said the cost of a vial of insulin in North Carolina tripled within a 14-month period.
“People shouldn’t be rationing their insulin,” said Smith, who led the still largely unknown Democratic field in a recent Fox News poll.
Cunningham’s campaign website touts his support for the Affordable Care Act, expanding Medicaid in North Carolina and creating a public health insurance option. He mentioned the ACA in a short speech after filing his official paperwork on Monday morning in Raleigh.
He said the Affordable Care Act “is under attack from people who don’t support that policy. I think we need to reinforce it, we need to stop attacking it. We need to make sure that we end the cliff that is leading to cost problems for so many families.” He also told reporters: “We need to make sure that we add a public option to it, which gives another choice for people here in North Carolina that otherwise don’t have access to quality affordable care.”
“I embrace the idea that we need to make sure that everyone has coverage — that everybody in North Carolina should have access to quality, affordable care.”
His website says Cunningham wants to “ensure no one loses their employer-sponsored coverage who wants to keep it.” That has been one of the top Democratic criticisms of Medicare For All — that Americans could lose their employer-provided health insurance under the plan.
Cunningham said the expansion of Medicaid that 36 states and the District of Columbia have embraced is “an important tool in the Affordable Care Act.” In North Carolina, many people make too much to qualify for Medicaid but too little to qualify for the ACA’s subsidies for private insurance.
Health care is the No. 1 issue among Democratic primary voters, according to a national poll by Quinnipiac.
Tillis on health care
Tillis is running in the Republican primary against challenger Sandy Smith. Retired Raleigh businessman Garland Tucker, who had largely financed his own challenge to Tillis, ended his campaign Monday.
Tillis voted to repeal the ACA in July 2017, but that vote failed in the Republican-controlled Senate.
The ACA was passed in 2010 and signed into law by President Barack Obama. It was his signature domestic policy achievement, and Republicans have vowed to get rid of it since its inception. It is often called Obamacare.
“I support anything that ultimately takes a failed health care plan — Obamacare — off the table, so that we can start talking about a sustainable one that will make health care affordable and actually make people healthier,” Tillis told Spectrum News in July.
The original law established health insurance marketplaces, allowed states to expand Medicaid and created a tax penalty on those who did not obtain health insurance.
Republicans did away with the penalty in the 2017 Tax Cuts and Jobs Act. The penalty was one of the main reasons the Supreme Court had found the mandate constitutional in 2012. The law, now without the penalty, is being challenged again. A lower court ruled the law unconstitutional and a decision by the 5th Circuit U.S. Court of Appeals is expected soon. The Trump administration is not defending the law, instead siding with states that want it overturned.
An appeal to the Supreme Court is expected no matter the ruling. But if the ACA is declared unconstitutional, protections for pre-existing conditions and expanded Medicaid in the states could also go away.
The Affordable Care Act also contains popular provisions such as not allowing insurance companies to deny coverage to people for pre-existing conditions and allowing children to remain on their parents’ health insurance until 26.
Tillis introduced legislation to protect coverage for pre-existing conditions in 2018, but it was panned by critics as insufficient. One called it a mirage. Earlier this year, Tillis introduced The Protect Act, which was co-sponsored by 22 Republican senators. He said he also wants to allow young adults to remain on their parents’ health insurance.
“I strongly believe that no hardworking American should ever have to go to bed worried about being denied coverage or treatment if they or their children have a pre-existing condition,” Tillis said in announcing the legislation.
Opponents of the bill said it would not cap out-of-pocket costs or require coverage of essential benefits, which are features of the Affordable Care Act.
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This story was originally published December 4, 2019 at 1:15 PM.
