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A coalition of union and liberal groups began running television ads on health care reform in North Carolina focused on getting the attention of one particular television viewer: Sen. Kay Hagan.

There is ongoing debate in the U.S. Senate over how to craft a national health reform plan called for by President Barack Obama. The central idea is to create a system that ensures all Americans have health coverage rather than leaving tens of millions uninsured.

Among the most fiercely contested ideas is whether to create a “public option” provider. Such an insurer would be organized by the federal government and would cover those who otherwise couldn’t get insurance or whose employers did not provide it.

Hagan is among those senators who have expressed reservations.

To pressure her and other senators, Health Care for America Now is backed by the AFL-CIO, ACORN, MoveOn.Org and the NAACP and has bought $1.1 million worth of television in 10 states, including North Carolina. The ads urge viewers to call their senators.

Most of the other states in which the ads will run are home to members of the powerful Senate Finance Committee. Hagan serves on the Health, Education, Labor and Pension Committee, which has first crack at crafting a plan.

Although the ad says generically, “Tell your senator — It’s your health. It should be your choice,” a spokesman for the group says the North Carolina buy is aimed at Hagan.

It would be nice to think Republican Richard Burr might be won over, said Jeff Parcher, a spokesman for the Center for Community Change.

“But to be realistic,” Parcher said, “Kay Hagan is the person everybody expected to be on board who has wavered a bit.”

Hagan twice this year has garnered national attention for being reluctant to go along with party leaders on a major national health policy issue.

Hagan this month was the only Democrat to vote against allowing the U.S. Food and Drug Administration to regulate tobacco products.

“Sen. Hagan is looking at all the public option proposals,” said spokesman David Hoffman. “She’s going to be working with her colleagues to ensure private health insurance isn’t going to be destabilized.”

Hoffman said Hagan was concerned that millions would drop their existing private health insurance and flock to a public option provider, leading to a collapse of the private health insurance market.

“Right now it’s too early to say if she favored one (public option proposal) over another,” Hoffman said.

Rather than destabilize private insurers, Parcher said the aim of the legislation would be to create competition that would force private insurance companies to lower costs and provide better service.

Hagan’s reticence on the public option plan has angered some, particularly Democrats on the liberal end of the party who helped her topple Republican Elizabeth Dole in 2008 and see the party’s strong majority in Congress as a chance to push through legislation long resisted by Republicans.

“She’s obviously sort of conflicted,” said Andrew Taylor, a political science professor at N.C. State. Health care, and in particular health care for uninsured children, was an issue that helped Hagan win against Dole.

But Hagan has a strong businesses background and was seen as a business-friendly senator during her 10 years in the General Assembly. To boot, Taylor said, the average Democrat in North Carolina is more conservative and more skeptical of government solutions than the average member of the Democratic caucus in Washington.

“Taking all those things into consideration and you would not think she would be marching in lock-step with (Democratic Majority Leader Sen.) Harry Reid all the time,” Taylor said.

Hagan’s reluctance to go along with party leaders on health care reform got extra attention this week when the Washington Post published a review of senators’ health-related stock investments. That report showed Hagan had more than $180,000 invested in health companies.

“That’s a really interesting sidelight in this whole story,” said Parcher, who said Hagan’s ultimate decision on whether to back a public option could be seen as siding with those corporate interests or not.

But Hoffman said that the Post totaled figures held by Hagan, her husband and a trust fund that she doesn’t control. Also, those investments were among dozens of other stocks the family holds.

He said that Hagan’s holdings would “absolutely not” be an obstacle to her making an impartial judgement on any health care bill.

Contact Mark Binker at (919) 832-5549 or mark.binker@news-record.com