Pro-Democratic group says North Carolina Senate candidate Thom Tillis would let pre-existing condition protections disappear

A race in North Carolina has become one of the top battles in the war to control the U.S. Senate. Sen. Kay Hagan, D-N.C., is trying to win a second term and help keep the Democrats in control. But she is expected to face a tough race against one of several Republicans competing in the primary.

One of the leading candidates is Thom Tillis, the speaker of the North Carolina House. Patriot Majority USA, a pro-Democratic group operating independently of the Hagan campaign, has begun to run ads against Tillis, who has already benefited from a blizzard of ads against Hagan that were paid for by the conservative group Americans for Prosperity.

Here’s the narration of the ad:

"In North Carolina, we put families first. But Senate candidate Thom Tillis sides with health insurance companies. He'd let them deny coverage for pre-existing conditions and raise rates for women needing mammograms. Tillis supports a plan that would end Medicare as we know it, and force seniors to spend up to $1,700 more for prescriptions. He's with the special interests; hurting North Carolina families."

We wondered whether it was true that Tillis would let insurance companies "deny coverage for pre-existing conditions."

In making the claim about pre-existing conditions, the ad cites a Charlotte Observer article from Sept. 23, 2013. That article, in turn, cites a comment from Tillis that we tracked back to a news release from his campaign.

In it, Tillis said in part, "Many have asked where I stand in the battle to defund Obamacare. … I believe Obamacare is a mortal threat to our economy. It will decrease health care quality and raise health care premiums, and Republicans should do everything in our power to undo it. That means we must use every tool available to us."

A spokesman for Patriot Majority told PolitiFact that "Tillis wants to repeal the ACA. Fact. If you repeal the ACA then … people could be denied coverage based on pre-existing conditions. Fact."

But is it as simple as that? Not necessarily.

It’s fair to assume that if Obamacare is repealed -- and, importantly, if nothing is passed in its place -- then the law’s consumer protections against getting denied for a pre-existing condition would disappear with it. But at least some Republican congressional leaders have been saying that they want to "repeal and replace" the law.

In fact, just in the past few weeks, three GOP senators -- Richard Burr of North Carolina, Tom Coburn of Oklahoma and Orrin Hatch of Utah -- have put forth a proposal that would do just that. Most important to this fact-check, their proposal would keep the pre-existing conditions protection in Obamacare -- a provision that’s generally popular even among critics of the overall law.

The Burr-Coburn-Hatch proposal isn’t as ironclad on pre-existing conditions as Obamacare is. It would allow a one-time window to get pre-existing conditions grandfathered into coverage, and protection as long as coverage is continuous. But beyond the initial grandfathering period, any lapse in coverage would mean the next policy someone buys would not necessarily cover pre-existing conditions.

This protection isn’t as sweeping as it is under Obamacare, but it’s better than what existed before Obamacare. For the purposes of this fact-check, however, we will consider this to be one way of keeping some form of pre-existing conditions protection.

So we checked with Tillis’ campaign to see whether he supported the Republican plan or if he wants simply to repeal Obamacare, as the ad suggests.

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Here’s what Tillis’ campaign manager and spokesman, Jordan Shaw, said:

"Speaker Tillis doesn’t believe that the Affordable Care Act is the only way to address health care problems. While he hasn’t officially endorsed the Burr-Coburn-Hatch plan because he hasn’t had a chance to discuss it in detail with Sen. Burr, he does think there are many good ideas in the plan. It is certainly a positive step toward a conservative alternative to Obamacare."

So Tillis is open to legislation that would replace Obamacare, but he hasn’t endorsed the main Republican plan currently on the table that, among other things, would include some protections for people with pre-existing conditions.

So what about his past statements? Has Tillis said the health care law should be replaced with something that keeps popular elements of the law in place?

We asked Shaw twice if he could provide documentation -- in speeches, news releases or videos -- of cases where Tillis made this point. But he didn’t reply.

So we looked ourselves. We didn’t find any. Most often, we found, Tillis has used the word "repeal" without adding "replace." For instance:

• The "Meet Tom" page on Tillis’ website: "As North Carolina’s U.S. senator, Tillis will push for repeal of Obamacare, a balanced budget, and conservative economic policy."

• A statement criticizing Senate Majority Leader Harry Reid, D-Nev.: "My campaign to beat Kay Hagan is the key to a new conservative majority that will repeal Obamacare and balance the budget."

• A tweet during the State of the Union address: "Obamacare's not working. Support repeal & end its $819.3 billion tax burden. #AskObama --> http://dld.bz/dg7Ca  #SOTU."

The closest he comes is another page on his website, where he says, "Thom will fight in the Senate for full repeal of Obamacare, for defunding Obamacare, and he will work to implement private-sector solutions to reduce health care costs for North Carolinians."

Still, not only is his support for "private-sector solutions" vague, but he specifically cites solutions that "reduce health care costs," not ones that keep people from getting insurance if they have pre-existing conditions.

Tillis is engaged in a primary against candidates fighting to win support among Republican base voters who are the hardest-line opponents of Obamacare. Given this situation, acknowledging that there are even small parts of Obamacare worth saving can be electoral suicide.

However, constantly calling for repeal without acknowledging there may be a need to replace the law with something else makes it hard to be too critical of an ad that infers that he would let insurance companies "deny coverage for pre-existing conditions."

Our ruling

Patriot Majority USA’s ad said Tillis would let insurance companies "deny coverage for pre-existing conditions."

Tillis’ staff says he is open to replacing the law, perhaps with the Burr-Coburn-Hatch proposal, but he hasn’t endorsed it yet. More importantly, we don’t find examples in which Tillis has publicly advocated replacing Obamacare with something else, at least not prior to our asking him about it in regards to this ad. 

Given all of this, we can’t really blame Patriot Majority USA for drawing the conclusion that Tillis would repeal Obamacare and not replace it. Still, we're left with an element of uncertainty about what Tillis' position on pre-existing conditions actually is. Overall, we rate the claim Mostly True.