WASHINGTON — Sen. Kay Hagan, D-N.C., on Thursday defended the expansion of Medicaid under the Affordable Care Act, saying it would provide health coverage for 500,000 people in the state who need it.
In an interview Thursday, Hagan said her support for the expansion underscored a big difference between her and Thom Tillis, the Republican state House speaker who hopes to unseat her in November.
“That’s just one example of Thom Tillis not understanding North Carolina and not understanding North Carolina values,” Hagan said.
The General Assembly, with Tillis in the leadership, turned away Medicaid expansion for 500,000 people in the state that would have been paid for by federal funds. Republicans have made Hagan’s support for the Affordable Care Act one of their top lines of attack against her since the fall. Polls in the state showed the law was unpopular.
Asked if she’d defend the law, Hagan said, “I voted for it. I think there are common sense fixes that must be made to this bill. But I also talked to people all across North Carolina who have seen the difference that that has made in their lives.”
She said the fact that enrollments in North Carolina are the fifth highest in the nation “shows the need for affordable health care for people in our state.”
Tillis, she said, “is not being up front about what it is that he wants. He says he likes some of the good things, but . . . all he’s saying is repeal, repeal, repeal. That would take us back to a time where if an individual had a pre-existing condition, you would no longer have access to health care. A third of the people in North Carolina when they would sign up on the individual market prior to the Affordable Care Act were turned away. Women automatically paid more than men, and our seniors paid more for prescription drugs.”
Tillis spokesman Jordan Shaw said the GOP Senate candidate has been clear that he wants to repeal the health care law first and then talk about solving health care problems with market-based ideas, such as allowing people to buy insurance across state lines and setting up high-risk pools.
He also said that Hagan had said often that people could keep their health care plans if they liked them, which proved not to be the case for many.
Earlier Thursday, at the Senate confirmation hearing of Office of Management and Budget Director Sylvia Mathews Burwell to head the Department of Health and Human Services, Hagan spoke about the estimated 500,000 impoverished state residents who fall into the Medicaid coverage gap, but would gain coverage under the health care law’s Medicaid expansion.
Currently, they earn too much to qualify for health coverage under the Medicaid program, which serves the poor and disabled, but not enough to get federal subsidies to help purchase insurance on the state's marketplace.
North Carolina is one of 24 states that chose not to expand eligibility for Medicaid under the Affordable Care Act, even though the federal government would pay all of the costs for new enrollees for the first three years and no less than 90 percent of their costs thereafter.
Shaw contended that state Democrats, including Hagan when she served in the state Senate, mismanaged Medicaid in the past and left a "broken" system that needed to be fixed before it could be expanded. He said the state could not be certain that the federal government would pay for the expansion as it said it would or that the Affordable Care Act would work.
At her hearing, Burwell testified that people in the so-called "coverage gap' will not have to pay the penalty for violating the law’s individual mandate, which requires most Americans to have health insurance or pay a fine for noncompliance.
Hagan, who serves on the Senate Health, Education, Labor and Pensions Committee, which held the Burwell hearing, had requested an HHS Inspector General and Government Accountability Office review of the botched HealthCare.gov rollout last fall. She asked Burwell what lessons she learned from the flawed website launch and how she would improve management of the federal marketplace portal.
Burwell said the government is working on ways to improve federal procurement and project accountability.
In the interview after the hearing, Hagan said that besides the Medicaid issue, in the contest against Tillis she would focus on his record in the state legislature: his support for tax cuts for the wealthy, his opposition to teacher raises and the cuts in unemployment insurance.
"I talk to people in North Carolina every week," and middle-class families are still struggling, she said. "North Carolina needs a voice like mine to speak on behalf of North Carolinians.”
Alleging that Tillis “is bought and paid for by the special interests,” Hagan said, “I think there will be a huge contrast in this race."
Tony Pugh of the Washington Bureau contributed.