BISMARCK-North Dakota Democrats and Republicans continue to sound off on the state's entry into a federal lawsuit to overturn the Affordable Care Act, as the health care debate also permeates North Dakota's Senate race.

State Insurance Commissioner Jon Godfread, Attorney General Wayne Stenehjem, Lt. Gov. Brent Sanford, state Sen. Kelly Armstrong and Rep. Kevin Cramer gathered Wednesday to "help set the record straight" on the dispute over health care.

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Cramer, who is challenging Heitkamp for her Senate seat, criticized the "perpetual myth" that "Republicans don't care about people with preexisting conditions." He also said Congress next year could take up legislation similar to the Graham-Cassidy amendment to the American Health Care Act, which failed in 2017.

Godfread and Sanford highlighted the Comprehensive Health Association of North Dakota for persons with preexisting conditions, as well as more state control for health insurance.

"Prior to implementation of the ACA, North Dakota didn't have the problems that the ACA sought to fix," the first-term insurance commissioner said, adding that about 8 percent to 10 percent of state residents are uninsured -about the same percentage as before passage of the ACA in 2010.

Stenehjem said his consultation with Godfread on the ACA's impact in North Dakota reinforced his decision to enter the Texas federal lawsuit. He also said the repeal of a tax penalty in the ACA has left the federal health care law without a leg to stand on.

"As a result, it appears obvious to me and 19 (other attorneys general) that the statute is unconstitutional," Stenehjem said.

Earlier in August, state Democratic-NPL party leaders called for Stenehjem to withdraw from the suit. Stenehjem said the case "would proceed nonetheless," but "we don't have to wait for the lawsuit to conclude for Congress to do the right thing."

Democrats have also said the lawsuit, if successful, would end Medicaid expansion the state Legislature passed in 2013. Godfread said the state law "won't be impacted by any changes with the federal side," but state legislators may return to look at it.

He also stressed what he sees as benefits of state control.

"State-based regulation works," Godfread said. "It's something we're proud of. We've got a long track record with it, and we continue to encourage Congress and everybody to turn that back over to the states."

Armstrong, the Republican nominee for U.S. House, also emphasized trouncing federal regulations for state control. In response to the GOP, Democratic-NPL House nominee Mac Schneider described the lawsuit as "reckless" in that it he sees it as threatening to patients with preexisting conditions afforded coverage under the law.

"You can't be in court arguing to a court that you're going to try to eliminate the preexisting conditions (protection) and say you want to protect preexisting conditions," former attorney general and U.S. Sen. Heidi Heitkamp said. "It just does not work."

She and Schneider each pointed out what they see as a lack of a plan or replacement for the ACA should it be struck down. Heitkamp has previously said the ACA should be remedied with legislation and highlighted her health care reform efforts in a press conference with national media.

But Cramer said something "Graham-Cassidy-like" could come up in Congress, with more flexibility and block grants for states, while keeping an eye out for people with preexisting conditions.

Heitkamp criticized her opponent for making health care "a political talking point," while Cramer said Democrats have made the issue "a theme to try and ride into this election cycle."