During Sylvia Mathews Burwell's May confirmation hearing to become HHS secretary, Sen. Kay Hagan of North Carolina decried that her state had not expanded Medicaid and as a result roughly 500,000 residents do not have health coverage.
“These are some of the most vulnerable citizens in our society who will continue to seek care in emergency rooms and then will leave chronic conditions unmanaged, which we know is detrimental not only to their health, but certainly to the economy, too,” the first-term Democrat said.
Her comments were a rare instance of a Democratic senator in a tough re-election campaign defending the Patient Protection and Affordable Care Act, which she voted for in 2010. But it also highlighted the fact that Democrats, while still largely on the defensive about the healthcare law, have found ways to tout its accomplishments on the campaign trail. The expansion of Medicaid—which roughly half the states have enacted—is one major provision of the ACA that Hagan and other Democrats have rallied around as they face a difficult electoral climate in November.
Hagan has been bludgeoned by millions of dollars in TV ads attacking her support for the law. But there's a big political disconnect in her state, given that more than 350,000 North Carolinians have signed up for exchange coverage, one of the highest rates in the country. At every opportunity, her Republican opponent, state House Speaker Thom Tillis, gleefully reminds voters of Hagan's repeated promise that anyone who liked their insurance would be able to keep it under the law—a claim that turned out to be partly false.
“It's all about healthcare and Obamacare,” said Michael Bitzer, a political science professor at Catawba College in Salisbury, N.C. “It's the No. 1 bullet that the Republicans are going to use.”