ANALYSIS — North Carolina has not voted for a Democratic presidential ticket since doing so — narrowly — in 2008. President Joe Biden and Vice President Kamala Harris sent their clearest signal yet Tuesday they will make a push to change that.

Then-Sen. Barack Obama took the Tar Heel State 16 years ago by about 14,000 votes. North Carolinians then went for Republicans Mitt Romney in 2012 and Donald Trump in 2016 and 2020. Polls show Trump leading there just over seven months from Election Day.

But a Morning Consult-Bloomberg poll of registered voters in a handful of swing states showed Biden gaining ground since his March 7 State of the Union address. After trailing in North Carolina by nearly double-digits a few weeks ago, that survey put him within 6 percentage points of Trump.

The president and his campaign have been going at Trump more directly in recent weeks, with Biden last week repeatedly mocking his predecessor’s finances after Trump was unable to post a $454 million bond in a New York state civil fraud case. And Biden’s campaign on Monday poked fun at Trump’s recently light campaign schedule, accusing him of campaigning from his “country club.”

“There’s a lot of people laying in bed at night literally wondering what will happen if my spouse gets cancer, my child gets seriously ill. Will I have enough insurance?” Biden said. “Can we afford the medical bills or will we have to sell the house? … We changed that and made the Affordable Care Act the law of the land.

“Donald Trump and his MAGA friends are nothing but persistent. They’ve tried to repeal it 50 times. … We’ve stopped them every time,” he added. “I’ve got news for them: we’re going to stop them again.”

Here are three takeaways from Biden and Harris in the Tar Heel State.

‘Extremists’

The cost of and access to health care likely will be a big focus of the Biden campaign’s messaging in North Carolina until November. Harris dubbed Biden one of the country’s great “champions” of access to care.

Taking the stage in a Raleigh community center before her boss, Harris said “extremists … want to take away” coverage for seniors, working families and Americans with pre-existing conditions. Without calling out Republicans, she repeatedly used the word “extremists” — including when discussing the termination of federal abortion rights, saying that Supreme Court created “a health care crisis with real harm” by overturning the Roe v. Wade precedent.

Biden called on Congress to pass a measure that would expand tax credits granted by the Affordable Care Act after vowing Trump “and his MAGA friends” would not be able to repeal the 2010 health care law. He touted his record, including helping the Medicare program negotiate lower prescription drug costs, and said he wants to expand that to more Americans in a second term.

White House aides during a Monday evening call previewing the event contended that Biden, working with the state’s outgoing Democratic governor, Roy Cooper, had expanded Medicaid coverage via the Affordable Care Act to 600,000 residents there. The aides, granted anonymity to speak candidly, told reporters those same North Carolinians could lose that coverage if Trump’s campaign proposals become law.

“Republicans in Congress want a national abortion ban. President Biden will veto that,” Anita Dunn, special adviser to Biden said Monday. “In the face of relentless, politically-driven attacks by Republican officials, President Biden is fighting for access to contraception. … That’s the split screen on health care you will see on clear display. … Republicans want to gut health care, raise prices, and rip away those basic reproductive freedoms.”

‘MISINFORMATES’

Trump fired off a post on his social media platform shortly before Biden and Harris hit the stage that amounted to a prebuttal.

“I’m not running to terminate the ACA, AS CROOKED JOE BUDEN DISINFORMATES AND MISINFORMATES ALL THE TIME,” the presumptive GOP nominee wrote. “I’m running to CLOSE THE BORDER, STOP INFLATION, MAKE OUR ECONOMY GREAT, STRENGTHEN OUR MILITARY, AND MAKE THE ACA, or OBAMACARE, AS IT IS KNOWN, MUCH BETTER, STRONGER, AND FAR LESS EXPENSIVE.

“IN OTHER WORDS, MAKE THE ACA MUCH, MUCH, MUCH BETTER FOR FAR LESS MONEY (OR COST) TO OUR GREST AMERICAN CITIZENS, WHO HAVE BEEN DECIMATED BY BIDEN, HIS RECORD INFLATION, BAD ECONOMY, AFGHANISTAN CATASTROPHE, AND JUST ABOUT EVERYTHING ELSE,” he added.

Trump assessed his successor and expected general election foe: “CROOKED JOE BIDEN IS, BY FAR, THE WORST PRESIDENT IN THE HISTORY OF THE UNITED STATES! MAGA2024.”

Hours later, Biden mocked Trump for, as president in April 2020, suggesting Americans inject disinfectant to kill the COVID-19 virus. The president also said Trump and his allies are responsible for the sometimes-chaotic fallout from the Supreme Court’s decision to overturn a national right to abortion.

Trump posted about a poll from Redfield & Wilton, a London-based firm, that shows he “crushes” Biden in North Carolina.

‘Early investment’

Even before the Raleigh event, the Biden campaign made clear they view North Carolina as something of a swing state lite.

“After this trip, President Biden will have traveled to every battleground state following his State of the Union speech, meeting the voters who make up the campaign’s multiple pathways to 270 electoral voters where they are,” Julie Chavez Rodriguez, Biden’s campaign manager, wrote in a memo released Monday.

“Southern battlegrounds like North Carolina and Georgia make up a critical piece of those pathways,” she added. “In 2020, Georgia was the closest state in the country won by President Biden, and North Carolina was the closest state in the country won by Donald Trump, making them both extremely competitive states where early investment makes a difference.”

Team Biden has mocked Trump’s campaign on media calls for its lack of a ground game in key states.

Inside Elections with Nathan L. Gonzales rates Georgia as a “toss up” and North Carolina as “tilt Republican.”