Rep. Joseph Crowley (D-N.Y.), chairman of the House Democratic Caucus, at a 2016 news conference. “Republicans after today will own this bill and the impact it will have on the American worker,” Crowley said Wednesday of the GOP health-care legislation. (Alex Brandon/AP)

Rep. Erik Paulsen is a Minnesota Republican who survived one of the most competitive House races of 2016 by a surprising double-digit margin even as Donald Trump lost his suburban Twin Cities district by almost 10 points.

Four months later, Democrats have launched their campaign to unseat Paulsen in two years, and their weapon of choice is health care.

For the first time in eight years, Democrats are finally on offense on a key issue that could help them retake the congressional majority in 2018. As Republicans struggle to craft and pass a replacement for Obamacare, Democrats are sharpening their campaign messaging against Republicans such as Paulsen.

The new approach was on display at a House committee hearing early Wednesday. The panel rejected a Democratic request to postpone the hearing to consider the GOP plan to roll back and replace the Affordable Care Act. By noon, Democrats were holding Republicans’ feet to the fire.

“Paulsen recklessly voted to put his party before his constituents and go full steam ahead on this bill without even knowing how much it will cost, how it will explode the deficit, and how many Americans will lose their health insurance,” the Democratic Congressional Campaign Committee wrote in a release.

(The Washington Post)

The House Democrats’ campaign arm issued a batch of similar releases, targeting Republicans such as Illinois Rep. Peter J. Roskam — a colleague of Paulsen’s on the House Ways and Means Committee. Roskam’s suburban Chicago district is a new target for the party.

The question is whether Democrats can capi­tal­ize on this shift. There are already signs of some rust: The release slamming Paulsen accidentally included a reference to how “Roskam should slow down and consider the consequences.”

Democrats have struggled to explain the intricacies and benefits of the Affordable Care Act since they approved it — without any votes from the other side of the aisle — seven years ago.

Republicans, deriding the law as “Obamacare” before President Barack Obama adopted the term, regularly won the short-term fights in advertising wars and election debates, simply calling it a “government takeover” of an industry that would lead to “death panels” for the elderly. Fair or not, those simplistic explanations broke through to the public in a bigger way than Democrats’ complex explanations of the broad and complicated way in which the health-care system would change.

The messaging challenge is part of why the ACA remained steadily unpopular. From 2010 to 2016, anywhere from 35 to 48 percent of Americans approved of the law, according to the Pew Research Center. Only last month, when the prospect of repeal came into focus with Republicans controlling every lever of power, did a clear majority back Obamacare.

Democrats are betting that Republicans are heading straight into the same quagmire that the left faced in the early years of Obama’s presidency.

“Republicans after today will own this bill and the impact it will have on the American worker,” Rep. Joseph Crowley (D-N.Y.), chairman of the House Democratic Caucus, said, adding, “They will suffer the consequences.”

But Republicans pushed ahead with hearings in the Ways and Means Committee as well as the Energy and Commerce panel, hopeful that a vote to repeal Obamacare could pass the House this month and head to the Senate for final approval in early April. They have made a private calculation that there are three likely outcomes of the ongoing health-care debate, each with a different degree of political fallout.

The worst possible outcome, according to Republicans in both chambers, would be to pass a straight repeal of the 2010 law without any fixes to it. That would end coverage for many millions of Americans and would then require Congress to try to build out the replacement parts of it through normal rules, meaning a Democratic filibuster could block any conservative change.

The next possible outcome would be deadlock on the overhaul effort, leaving the ACA in place. That would probably leave conservative base voters upset with Republicans for failing to deliver on a long-promised goal to end Obamacare.

Instead, Republicans are pushing their top choice, a mix-and-match plan that leaves in place some popular ACA provisions while undoing key pieces such as a mandate to buy insurance, replacing it with tax credits to offer access to buying a plan.

They believe such an approach will meet the approval of conservatives, though several hard-liners and outside groups are already balking. GOP leaders would then turn the summer and fall of 2018 into a fight to capture middle-of-the-road voters. Their bet is that Democrats will fail to convert their overhaul efforts into real outrage, just as they have failed to scare the public about the conservative policy ideas of House Speaker Paul D. Ryan (R-Wis.) for five years now.

Shortly after Republicans took over the House in 2011, Ryan was chairman of the House Budget Committee and pushed through a plan calling for changing Medicare from a guaranteed benefit into a plan of premium supports. Democrats won a special election in May 2011 in Upstate New York that focused on the Medicare proposal, spurring false hopes that it would deliver them the majority.

N.Y. special election becomes referendum on GOP Medicare plan

But by September of 2011, Republicans had neutralized the issue in a Nevada special election, and Democrats have struggled ever since to make Ryan’s conservative ideas on taxes and entitlements into a polarizing campaign issue. Even with Ryan as the Republican vice presidential nominee, his Medicare proposal was largely a nonissue in the 2012 campaign.

Democrats believe now that Ryan’s proposals are possible — they never previously had any hope of becoming law with a Democrat in the White House — and that they will become more politically toxic as President Trump calls for their passage and is able to sign them into law.

Ahead of Wednesday’s hearings, House Democrats huddled with the new Democratic National Committee chairman, Thomas Perez. Afterward, Perez pointed to several different pockets of wavering Republicans as a demonstration of how the stakes have shifted.

“That’s why you’re observing the circular firing squad that is the Republican Party on health care,” Perez told reporters after the meeting

The former Obama labor secretary made clear who he expected to politically suffer.

“They made their own bed on this,” Perez said.

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