Thom Tillis’ record attacking health care, outlined in a new report from the News & Observer, is becoming more and more indefensible as COVID-19 continues to impact North Carolina and the country. Cal Cunningham continues to hold Tillis accountable for his record — from blocking Medicaid expansion as Speaker of the North Carolina House, to voting repeatedly to repeal the Affordable Care Act.
According to the News & Observer, while Tillis “has taken credit for being the one to stop Medicaid expansion in the state,” “Cal Cunningham has positioned himself as a defender of the law and proponent of Medicaid expansion in his race against Republican Sen. Thom Tillis.”
After blocking Medicaid expansion, Tillis ran ads in 2014 saying he “stopped Obama’s Medicaid expansion cold.” Years later, he’s still bragging about “making it illegal” to expand Medicaid in North Carolina. He has also voted to partially or fully repeal the Affordable Care Act 13 times in the U.S. Senate, has done nothing to stop the reckless GOP lawsuit that threatens the fate of the entire law, and says he supports anything that takes the ACA “off the table.”
Cal Cunningham’s health care priorities stand in stark contrast to Tillis. He has repeatedly advocated for Medicaid expansion and defended the Affordable Care Act and its protections for the 1.7 million North Carolinians living with pre-existing conditions: “We’re in the middle of a public pandemic and public health is a crisis and North Carolina has one of the highest percent of uninsured in the country because we’re one of the states that has not expanded Medicaid.” He’s also proposed including an incentive in the next coronavirus relief package for states that have not expanded Medicaid.
Thom Tillis has made a name for himself attacking health care, but “now the politics have been scrambled” and his toxic record may be unforgivable for North Carolina voters who are now experiencing the consequences of his decisions.
Read more below.
News & Observer: In race vs. Tillis, Democrat Cunningham makes pitch for Medicaid expansion
By Brian Murphy – June 30, 2020
- The Affordable Care Act, passed in 2010 and at the center of most national election cycles since, will again be a prominent issue in the 2020 election as new Supreme Court arguments over the fate of the health care law could be held in the weeks before Election Day.
- In North Carolina, where the fight over the law’s Medicaid expansion provision remains a key dispute between the the state’s Democratic governor and its Republican-led legislature, Democrat Cal Cunningham has positioned himself as a defender of the law and proponent of Medicaid expansion in his race against Republican Sen. Thom Tillis.
- Tillis, who previously served as speaker of the House in North Carolina, has been a vocal critic of the Affordable Care Act and used his opposition to the law to help unseat Sen. Kay Hagan in 2014.
- “Just one year ago this week, give or take, he was still proudly saying that he was the speaker who made it illegal for the governor to expand Medicaid, and then he has voted repeatedly to repeal the Affordable Care Act and Medicaid expansion is one of the key pieces of that important law,” Cunningham said in a video interview with McClatchy on Thursday.
- The Affordable Care Act, often called Obamacare, allowed for states to expand Medicaid eligibility as part of its effort to extend health care coverage to all Americans. North Carolina is one of 14 states that has not expanded Medicaid.
- When Tillis was speaker of the House, Republicans passed a bill in 2013 prohibiting Medicaid expansion without action by the lawmakers. It also stopped the state from running its own health benefit exchange. Tillis has taken credit for being the one to stop Medicaid expansion in the state, both at the time and more recently.
- “I am the speaker of the House who signed the bill that made it illegal to expand Medicaid under Obamacare. Because it was a bad deal, it wasn’t fiscally sustainable,” Tillis told Spectrum News last year.
- But the option to expand Medicaid may not exist for much longer if Republican attorneys general and the Trump administration win their case at the U.S. Supreme Court.
- The Trump administration, in a brief filed late Thursday, argued the “entire ACA must fall,” including Medicaid expansion and protections for individuals with pre-existing conditions, after congressional Republicans ended the law’s individual mandate to purchase health insurance in their 2017 tax reform bill.
- Tillis has voted several times in the Senate to repeal the Affordable Care Act, saying he would vote to get rid of it “every time it comes to the floor.”
- “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 said when asked about the lawsuit in 2019.
- Tillis has said he wants a replacement for the Affordable Care Act and introduced a measure to cover pre-existing conditions in 2018 when the lawsuit now at the Supreme Court was just getting started. Critics said the bill would allow insurance companies to not cover issues related to those preexisting conditions. His spokesman said at the time Congress would have to put forward a more comprehensive plan if the entire ACA were tossed.
- Cunningham said his campaign is the only one that is fighting for Medicaid expansion and other parts of the Affordable Care Act.
- “We’re in the middle of a public pandemic and public health is a crisis and North Carolina has one of the highest percent of uninsured in the country because we’re one of the states that has not expanded Medicaid,” Cunningham told McClatchy.
- In November 2010, Republicans won control of the North Carolina state legislature — as well as the U.S. House and Senate — in large part due to opposition to the Affordable Care Act, passed months earlier by Democrats and signed into law by then-President Barack Obama.
- In early 2013, Democratic state Auditor Beth Wood released an audit requested by the General Assembly into Medicaid in the state. It found structural problems — “administrative spending for the state’s Medicaid program is significantly higher (38%) than the average of nine states with similarly sized programs” — and other issues that led to hundreds of millions in shortfalls.
- Within weeks of the audit, state lawmakers passed the bill prohibiting the governor from implementing Medicaid expansion or setting up a state exchange.
- In his 2014 GOP primary, Tillis ran radio ads saying he “stopped Obamacare’s Medicaid expansion cold. It’s not happening in North Carolina, and it’s because of Thom Tillis.” In a GOP debate, he touted his fight against Obamacare.
- It was smart politics, particularly among Republicans. More people had an unfavorable opinion of the law for most of the time from March 2011 until early 2017.
- Now the politics have been scrambled, timed almost precisely with President Donald Trump taking office. With Republicans in control of the House, the Senate and the White House throughout 2017 and 2018, the chances for repeal shot up. The Senate, however, was not able to pass a bill, despite running several versions — outright repeal, repeal-and-replace and so-called “skinny” repeal in late July 2017. Tillis voted for all three. The first two would have ended Medicaid expansion.
- Many of the law’s provisions are very popular with Americans, across political lines, including allowing children to remain on their parents’ plans until 26, creating health care exchanges, helping low-income people purchase insurance and stopping insurance companies from denying coverage because of pre-existing conditions.
- Republicans eliminated the individual mandate to purchase insurance, the most unpopular part of the law, in their 2017 tax reform bill. Tillis voted for the bill.
- Now the Trump administration in its argument to the Supreme Court is saying those congressional Republicans wanted that action to collapse the entire law.
- Medicaid expansion allows for those earning up to 138% of the federal poverty level to qualify. It aims to close the gap between the very poor, who already qualify for Medicaid, and those with either employer-based health insurance or enough income to purchase health insurance or qualify for federal subsidies to help pay for it.
- In North Carolina, estimates of the number of people who could be added to Medicaid under expansion range from 300,000 to 600,000. But the coronavirus-induced economic troubles have led to extreme job losses, likely increasing the number of people who would qualify under expansion.
- “We have even more North Carolinians without health coverage today than we did even several months ago,” Cunningham said. “And Medicaid is a tool, right in front of us, that is available for North Carolina to help close that gap.”
- To encourage states to expand Medicaid, the Affordable Care Act said the federal government would pay 100% of the costs for the first three years of expansion, which would then fall to 90%.
- But Democrats in the House and Senate have proposed reinstating the more generous match for states who have not yet expanded Medicaid, like North Carolina. Cunningham proposed including it in the next coronavirus aid package.
- “We need a little bit of a kick in the pants here in North Carolina to get Medicaid expanded,” said Cunningham, who served one term in the state Senate in the early 2000s.
- If the Affordable Care Act — which has survived several legal challenges including a 5-4 decision in the Supreme Court in 2012 — remains in place, what happens next will largely be determined who wins control of Congress and the White House in November.