Health care remains in focus as Dem race enters endgame

“Cobb has pivoted and made health care a centerpiece in the campaign’s waning days, offering a preview of what a potential general election contest might look like between a candidate with a deep background in health care and the lawmaker who made repealing Obamacare a campaign centerpiece.”

JUNE 13, 2018

SARATOGA SPRINGS | Health care continues to animate candidates as they hurdle towards the finish line in a hard-fought Democratic primary contest for New York’s 21st Congressional District.

The five hopefuls made their closing arguments to voters Monday in Saratoga Springs for who is best positioned to go up against Rep. Elise Stefanik (R-Willsboro) in November:

Emily Martz, the unifier and job-creator. Dylan Ratigan, the government reformer and truth-teller. Katie Wilson, working class fighter. Patrick Nelson, populist policy wonk.

And Tedra Cobb, health care expert.

In a contest with no clear frontrunner, Cobb has pivoted and made health care a centerpiece in the campaign’s waning days, offering a preview of what a potential general election contest might look like between a candidate with a deep background in health care and the lawmaker who made repealing Obamacare a campaign centerpiece.

Again and again, Cobb circled back to the subject in the two-hour forum in what appears to be a calculated multi-pronged strategy to highlight the issue, joining a press release, 30-second television advertisement and direct mail pieces rolled out in quick succession.

Cobb repeatedly criticized Stefanik for voting to repeal Obamacare last May, citing numerous family members with health challenges — a daughter who required back surgery; a brother with lupus — as examples of people who would be directly harmed by Republican policies.

The candidate contended the GOP-crafted House replacement plan would have led to 64,000 residents in the district losing coverage, while a reduction in Medicaid dollars would have stripped health care facilities of a critical funding stream.

“I’m here right now running because Elise Stefanik has turned her back on all of us,” said Cobb, a consultant who spearheaded HIV/AIDS programming and co-founded a non-profit community health coalition in the late-1990s before serving two terms as a St. Lawrence County legislator.

Stefanik voted in favor of a Obamacare replacement plan last year that would have reduced Medicaid funding by $880 million, a measure critics argued would put the low-income residents who benefited from the expansions under the law at the greatest risk, jeopardizing services like drug treatment and mental health counseling.

The GOP plan would have rolled back Medicaid to the traditional 50-50 model as opposed to a 90-10 split. Each state would have been free to pick up the difference, which would have amounted to $2.3 billion in New York.


Lingering over the forum was a court case filed by the Justice Department seeking to dismiss some of the most popular provisions of the law, including protecting people with pre-existing conditions from being charged higher rates.

“It would essentially leave 52 million people without health care coverage,” said Wilson, citing a 2016 analysis by the Kaiser Family Foundation that revealed approximately 52 million Americans under the age of 65 could find their access jeopardized.

Wilson acknowledged Stefanik’s health care vote as a catalyst that energized the progressive movement in the district, and said pre-existing conditions appear to be increasing, citing an uptick in Lyme disease and mental health issues.

“This would probably be greatest attack to access to health care ever,” said Wilson.

Insurance premiums are rising by double-digits, largely due to the repeal of the individual mandate, which is scheduled to go into effect in 2019.

Nelson accused Republicans of sabotaging the law as part of a calculated strategy.

“They take something in government, and they break it,” he said. “And they point to the thing that they broke, and say, ‘Look, government can’t solve your problems.’

“Well, we see through that.”


Each of the five Democratic candidates agree on universal health care, but disagree on how to get there.

Nelson and Martz support Medicare for All, while Wilson has endorsed Sen. Chris Murphy’s proposal for Medicare buy-in on an open exchange, which would provide a bridge to universal care, a measure the candidate called a “no brainer.”

“This is something we can do now while we fight for a Medicare for All system,” Wilson said. “I’m a pragmatist, and we all know as a freshman member of Congress, there’s only so much you can do.”

Nelson disagreed, arguing without the individual mandate, a buy-in system will result in a dumping ground for the poor and sick.

“I don’t believe half measures are how we’re going to win and take office,” Nelson said. “It’s time for full-throated support for a Medicare for All system.”

Ratigan has made reforming the nation’s “broken political system” a campaign centerpiece, and has waged an asymmetrical campaign that has eviscerated Republicans and Democrats alike.

He excoriated Obamacare as the most damning example of government dysfunction.

The Democratic Party failed to provide health care when they had full control of Congress and the White House, he said, and lawmakers balked at the public option, or the creation of a government-run system.

“It’s not a mysterious concept,” said Ratigan. “It’s a political choice because the people who profit from our sickness and our death pay our politicians on both sides of the aisle. Unless you actually call it out and reform the Democratic Party, you will never have the obvious solutions that are available to each and every one of us.”

Ratigan said the two-party system leads to a misdirected sense of tribalism that should instead be directed at culling the influence of big government and corporations, an issue that transcends party lines.

“It seems to be working well with our campaign volunteers, half of which are independents and Republicans right now,” he said.

Cobb called Obamacare a “travesty on many levels” and lashed Republicans for failing to hold health care hearings.

The candidate often cites the need for “affordable and portable” coverage, and said Medicare for All is one possible option.

“We need to make sure that everyone has health care, and what it looks like right now may not be what’s in Congress right now,” Cobb said. “That’s the point of hearings. That’s the point of elected people doing their jobs. Getting professionals and experts in the room — not passing legislation in the middle of the night.

“There may be a better plan. I don’t know. But I’m open to listening.”

Lynn Kahn will be on the ballot in November as a Green Party candidate, but was not invited to the forum.

Stefanik has said she disagrees with barring access to patients with pre-existing conditions, and supports allowing people to stay on their parents’ health insurance plans up to the age of 26.

However, those measures must be joined by “market flexibility and increased choice,” she said at a forum in Moriah in April.

Lenny Alcivar, a Stefanik campaign spokesman, said the lawmaker “has a strong, independent record on improving quality and accessibility and lowering costs of healthcare.”

“She wrote the single biggest fix to Obamacare that was signed into law by President Obama,” Alcivar said, referring to the repeal of the auto-enrollment mandate. “She will continue to fight for families that have seen healthcare costs increases due to the fundamentally-flawed Obamacare.”

The sophomore lawmaker also helped drive $27 million in federal funding for low-volume hospital and Medicare-dependent hospital programs in the district earlier this year, a measure cheered by providers.

While criticized for failing to tip her hand on how she would have voted for the Affordable Health Care Act until the last minute, Stefanik had argued the need to better understand the legislation.

Stefanik had called for a multi-year transition process; attempted to ensure essential health benefits were not stripped from the legislation, and sought additional funding for maternity care and addiction services.


Stefanik, who is seeking a third term, was roundly criticized by the field beyond health care.

Nelson contended the lawmaker is at the mercy of her campaign donors, citing support from Paul Singer, the billionaire hedge fund financier who the candidate blasted as the “lowest of the low” in the financial sector.

“Over her career, Stefanik has taken more than $200,000 from health care industry political action committees,” Nelson said.

He also said the lawmaker’s contributions from “corporate PACs” steered her position on Wall Street deregulation, referring to her vote last year to roll back many of the Dodd-Frank regulations designed to prevent another financial meltdown.

“When push comes to shove, Elise Stefanik will side with her donors over the people of New York’s 21st Congressional District,” Nelson said.

Ratigan has seldom criticized Stefanik by name since entering the race nearly four months ago.

But he was prompted into doing so when organizers, the League of Women Voters of Saratoga County and Citizens Acting Together for the 21st District, asked candidates to specify which votes make Stefanik vulnerable as she seeks a third term.

Ratigan said Republicans have the responsibility to put the reins on a “self destructive and nihilistic” president who is the most “dangerous leader in history of free world,” but have failed to do so.

“The incumbent” should be held responsible, said Ratigan.

“One of the members of this party represents this district, and they’re not doing their job, and there’s a tremendous amount of risk right now,” he said.

Ratigan also criticized Stefanik as “the definition of a poster child of a career politician who has never worked a real job in their life.”

“She is a party asset” and a “tool of the party establishment,” he said, “and that alone is a reason for her to be defeated.”

Alcivar pushed back against Ratigan’s criticisms.

“Congresswoman Stefanik has worked incredibly hard in her professional life, whether at her family’s small business or in the West Wing of the White House,” Alcivar said. “She works hard every day in her job to deliver results as the North Country’s congresswoman. It’s not surprising to hear sexist, demeaning rhetoric from New York City talking head Dylan Ratigan. We suggest he re-watch the debate when one of her previous opponents, Aaron Woolf, accused her of not working ‘with her hands.'”

Martz zeroed in on the lawmaker’s environmental record and health care vote.

“These are all pieces of legislation we must and can hold her accountable for,” Martz said.

Cobb and Wilson criticized Stefanik for what they said was a lack of engagement with constituents.

“In an area like this which is very tribal in a way, people are not OK with an outsider representing them in DC,” Wilson said.

Stefanik, said Alcivar, has participated in over 740 constituent outreach district events, including 17 “Coffees with your Congresswoman” town hall-style events.


While Stefanik was a lightning rod for criticism, numerous candidates also lashed the Democratic Congressional Campaign Committee (DCCC) for their perceived aloofness and inability to learn their lesson following their crushing 2016 losses.

Most of the five candidates admitted they have not read the Democratic Party’s “A Better Deal” Platform.

“I do know is that a better deal for New York’s 21st Congressional District is a new representative to start with,” said Martz.

Ratigan was equally dismissive.

“I apologize for not reading the DCCC’s talking points before arriving here this evening,” he said.

Candidates also sounded off on gun control, the practice of bank redlining in the Adirondack Park, the ongoing crisis roiling the state’s dairy farmers, campaign finance reform and whether rank-choice voting should be explored at the national level.

Nelson said forums showcase how each candidate’s messaging has evolved over time.

He said he was the first to endorse Medicare for All, call for a reinstatement of the federal ban on assault weapons, push for rank-choice voting and prioritize ridding politics of corporate PAC money, platforms now adopted by several of his opponents.

“It’s a testament to the Democratic process and what your voices have been able to accomplish,” he said.

Alcivar contended the field is “desperate” and “one of the weakest in the entire country.”

“They continue to run further and further to the left embracing government run health care, which will be a trillion dollar tax increase on families,” he said. “It is sad to see the Democrats so desperate to gain traction. Congresswoman Stefanik is in the top 10 percent of most bipartisan members in Congress as recognized by The Lugar Center.”


Voters head to the polls on June 26.

In recent weeks, Martz has increasingly been branding herself as a unifier, stressing the need for Democrats to come together following the year-long primary contest.

Her campaign is spearheading a unity event in Queensbury on Election Night — with or without all five of the candidates.

“This moment in our district doesn’t come around often. We must unite, and this is how we win,” Martz said.

And in a staple of every campaign season, candidates griped about missing campaign signs.

Ratigan said he’s committed to supporting whoever wins the primary.

“With pleasure,” he said. “Although I would like whoever is stealing my yard signs to bring them back.”

Wilson said, “It’s true, it’s happening. There’s a lot of behind the scenes dirty stuff going on, but I can say with full certainty that I will certainly support whoever the nominee is.”

“If anyone sees my signs from Watertown that have been taken,” said Cobb. “I dunno. Maybe it’s the Republicans — they’re getting scared.”

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