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.
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