Butterfield faces newcomer Smith in this district.

1st Congressional District

Experience meets conservatism in race for NC’s First Congressional District.

Longtime congressman G.K. Butterfield, a Democrat from Wilson, faces political newcomer Sandy Smith, a Republican from Winterville. Here is their stance on health-related issues.

By Greg Barnes

G.K. Butterfield, incumbent, Democrat from Wilson

Age: 73

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Political experience: Butterfield has held the First District seat since 2004 and is a member of the Congressional Black Caucus, serving as its chair from 2015 to 2017. Prior to being elected to the House, Butterfield served as a state Superior Court judge and a Supreme Court judge.

Education/personal: Butterfield was raised in Wilson and graduated college and law school from N.C. Central University in Durham. He went on to practice law in Wilson for 13 years before becoming a judge. He is an Army veteran.

Campaign contributions: As of June 30, Butterfield had raised $616,930 for his campaign, spent $547,696 and had $580,742 on hand, according to OpenSecrets.org.

Sandy Smith, Republican from Winterville.

Age: Unknown

Campaign Website

Facebook page

Political experience: None

Education/personal: Smith and her husband, William, have four adult children and own a farm in Ayden, where they keep bees and free-range pigs. She graduated cum laude from East Carolina University with a bachelor’s degree in university studies in business and technology. She has worked in business throughout her lifetime, including for the Walt Disney Co., as a manager of a medical equipment company and as a staff accountant for an agricultural company in Lenoir County.

Campaign contributions: As of June 30, Smith had raised $851,156, spent $705,312 and had $145,843 on hand, according to OpenSecrets.org.


The Affordable Care Act

In June, Butterfield joined House Democrats to pass the Patient Protection and Affordable Care Enhancement Act. The legislation aims to build on the Affordable Care Act (also known as Obamacare) by lowering health care costs and prescription drug prices for eligible Americans.

“In the midst of a pandemic, access to quality, affordable health care is more important than ever for families throughout North Carolina and across the country,” Butterfield said in a statement on his website.

On the ivoterguide website, Smith said she strongly disagrees that it is the government’s responsibility to ensure that everyone has health insurance, and she rejects the idea of eliminating private healthcare insurance.

“The government has no business being in healthcare. Open the market so people can make their own healthcare choices. Obamacare was totally unconstitutional,” she said on the website.

Reproductive health

Butterfield supports a resolution introduced in the House last year that would ensure all women have access to comprehensive, preventative and affordable health care services and are able to receive unbiased information about those services.

Butterfield is also a co-sponsor of a bill introduced in 2019 that aims to protect a woman’s ability to determine whether and when to bear a child or end a pregnancy, and to protect a health care provider’s ability to provide reproductive health care services, including abortion services.

Smith is pro-life and is endorsed by the National Right to Life PAC.

“I believe that life begins with conception,” she said on her website. “I believe that late and so-called “fourth term abortions” must be prohibited without exception.”

Medicaid expansion

North Carolina is among 12 states that did not opt for Medicaid expansion when it became available through the Affordable Care Act in 2013. As a result, an estimated 500,000 low-income residents, mostly workers, don’t qualify for Medicaid and earn too much to qualify for an insurance plan on the federal marketplace.

In 2017, Butterfield and other North Carolina lawmakers sent a letter to the Centers for Medicare and Medicaid Services strongly supporting that the state expand Medicaid.

“Since the passage of the Affordable Care Act in 2010, I have urged our governor to expand Medicaid and provide more quality health coverage for North Carolinians,” Butterfield said on his House website. “Access to basic health coverage is a right that all North Carolinians and Americans deserve and I stand ready to protect the Affordable Care Act and Medicaid from Republican efforts to derail the healthcare progress we have made.”

Smith and Butterfield did not respond to a request from NC Health News to provide their stances on major issues, including Medicaid. Smith does not address the question of Medicaid expansion on her website, but she did offer this:

“Healthcare must be focused on the patient, and based on a free and open market. I strongly support efforts to open up competition across state lines, which will lower healthcare costs for North Carolinians and encourage new providers to open in our small towns.”

Masks/no masks

In July, Butterfield asked House Speaker Nancy Pelosi to change the rules so that all House members and staff are required to wear a mask on the House floor.

“Many of my Republican colleagues refuse to wear a mask on the House floor. I disliked that a few weeks ago when I saw it, but now I’m angry,” Butterfield told Congressional Quarterly Roll Call.

Smith: Did not respond and has little or nothing in the public record on this topic.

The opioid crisis

Joining more than 50 other congressional leaders in 2017, Butterfield cited the opioid crisis in his hometown of Wilson during a subcommittee hearing on Capitol Hill.

According to the Wilson Times, Butterfield said he had worked closely with colleagues on the Comprehensive Addiction and Recovery Act, which was passed into law and provides grants to states to support prevention, treatment, recovery and education efforts around the opioid crisis. The law also expanded access to the overdose reversal drug naloxone.

Smith: Did not respond and has little or nothing in the public record on this topic.