Virginia Lt. Gov. Ralph Northam (D), who is seeking the Democratic gubernatorial nomination, called health care a privilege during a debate six years ago, his opponents campaign revealed on Tuesday.

Video of Northam in the 2011 debate , when he was running for re-election to the state Senate, shows him responding to a question asking whether he considers health care a right, or something best left to the market or charity.

I believe its a privilege, Northam said in the video, circulated by former Rep. Tom Perriello (D-Va.), his rival in the gubernatorial primary. And let me clarify that: If people can get up in the morning and go to work like I can, then it needs to be a privilege. They need to work for their health insurance, for their benefits. If theyre disabled, I will take the shirt off my back to help them.

Northam, a pediatric neurologist and Army veteran, now views affordable health care as a right, according to David Turner, a spokesman for his campaign.

Ralph Northam spent his life seeing patients as an Army doctor and a pediatrician, and he knows firsthand how important for people to be able to get the health care they need, when they need it, Turner said in a statement. He firmly believes that every American and Virginian has a right to affordable health care, and he believes it is the responsibility of government to make sure they do.

Turner also pointed to Northams advocacy for the expansion of Medicaid in Virginia, and co-sponsorship of legislation, as a state senator, that would have created a state-run Obamacare exchange in the state. In 2010, Northam was one of 17 state senators to vote against a bill getting rid of the individual mandate in Virginia.

The revelation about Northams 2011 comments nonetheless lands a blow for Perriello, who has cast himself as the more progressive of the two candidates and emphasizes his support for health care reform in the wake of the House of Representatives passage of a controversial Obamacare replacement bill.

In an advertisement released moments after the House passed the Trumpcare bill, Perriello stands in front of an ambulance being crushed in a compactor symbolizing GOP attempts to overturn health reform. Speaking over the loud noise of the compactor, he touts his vote for Obamacare as a congressman and promises to prevent a figurative ambulance-crushing scenario in Virginia.