DALLAS — Rep. Pete Sessions Peter Anderson SessionsThe Hill's Campaign Report: New polls show Biden leading by landslide margins The Hill's Morning Report - Presented by Argentum - In Rose Garden, Trump launches anti-Biden screed Pete Sessions wins GOP runoff in comeback bid MORE’s (R) north Dallas district has become ground zero for the fight over health care and pre-existing conditions, the dominant issue in many contests across the country that could help determine the next House majority.

Sessions, 63, has been in Congress for 22 years, but has seen the 32nd District become increasingly diverse and more competitive. He won reelection in 2016 without a Democratic challenger even as Hillary Clinton Hillary Diane Rodham ClintonBloomberg rolls out M ad buy to boost Biden in Florida Hillicon Valley: Productivity, fatigue, cybersecurity emerge as top concerns amid pandemic | Facebook critics launch alternative oversight board | Google to temporarily bar election ads after polls close Trump pledges to make Juneteenth a federal holiday, designate KKK a terrorist group in pitch to Black voters MORE won the district over President Trump Donald John TrumpFederal prosecutor speaks out, says Barr 'has brought shame' on Justice Dept. Former Pence aide: White House staffers discussed Trump refusing to leave office Progressive group buys domain name of Trump's No. 1 Supreme Court pick MORE by nearly 2 points.

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His race against Democrat Colin Allred, a former NFL player who worked in the Obama administration, is seen as a toss-up, and top Republicans are battling hard to save the incumbent, a former member of House leadership.

Allred, 35, has sharpened his attacks on the Republican’s record on health care. Sessions has voted to repeal the Affordable Care Act, also known as ObamaCare, numerous times, a fact the Texas Democrat repeatedly reminds voters about in stump speeches and ads.

Sessions has sought to defend himself by highlighting a resolution he offered in September that would allow states to reform individual health-care marketplaces, while making sure people with pre-existing conditions can access health care with lower premiums and deductibles.

But the resolution is nonbinding, and the Republican is also opening himself up to attacks since Texas’s attorney general has led a lawsuit — backed by the Trump administration — that would undo ObamaCare and its popular provision protecting those with pre-existing conditions.

Democrats believe that relentlessly focusing on health care can be a winning message as they look to flip 23 House seats in the election — many in suburban battlegrounds similar to Sessions’s district and traditional GOP strongholds moving to the center thanks in part to demographic changes.

On a cold and rainy night last week, at least 100 people gathered at an athletic center in the Dallas suburbs to attend the Dallas County Democratic Party’s annual fish fry, an event that featured Allred.

Less than a minute into his speech, as the participants ate fried catfish, Allred had already started hammering Sessions over his “political stunt” in introducing a pre-existing conditions resolution, while attacking the congressman’s voting record on repealing ObamaCare.

“I think it’s the worst kind of Washington politics. I think people are so sick of that kind of cynical, political stunt,” Allred told The Hill at the fish fry.

“When you get in a close election a month out, you propose a nonbinding resolution saying you support pre-existing conditions, I think people see through that and they resent it.”

And like many Democrats around the country, Allred has seized on Senate Majority Leader Mitch McConnell Addison (Mitch) Mitchell McConnellDemocratic senator to party: 'A little message discipline wouldn't kill us' House to vote on resolution affirming peaceful transition of power Republican lawyers brush off Trump's election comments MORE’s (R-Ky.) comments about trying again on a bill to repeal ObamaCare.

The race is attracting national attention. Several national political reporters, along with a tracker from the Texas Democratic Party, followed Sessions along on a block walk — a Texas term for canvassing — around the leafy neighborhood of Far North Dallas to meet with constituents and potential voters.

More than 50 volunteers attended last weekend’s block walk to canvass the neighborhood, which included people from Rep. Kevin Brady Kevin Patrick BradyBusinesses, states pass on Trump payroll tax deferral Trump order on drug prices faces long road to finish line On The Money: US deficit hits trillion amid pandemic | McConnell: Chance for relief deal 'doesn't look that good' | House employees won't have payroll taxes deferred MORE (R-Texas) and Gov. Greg Abbott’s (R) teams.

Speaking with reporters on a brisk, sunny morning last weekend, Sessions lashed out at “shameless” Democrats for their portrayal of his health-care record. And he also sought to blunt those attacks by seizing on some Democrats’ push for “Medicare for all,” which would institute a single-payer health-care system.

“It’s an absolute, despicable lie nationally that the Democratic Party is attempting to put across,” Sessions said, mentioning that his 24-year-old son has Down syndrome and has always had access to good health care.

“And the bottom line is they’re desperate for people not to know how bad their plan is,” he said. “They will outlaw all private insurance in the country that competes against their blessed government program.”

During a heavily contested Democratic primary, Allred said he supports “Medicare for all,” but during a September debate, he said he wouldn’t back a single-payer system funded by taxes.

Millions of dollars spent from outside groups on both sides of the aisle have made this one of the most competitive battlegrounds this cycle.

Congressional Leadership Fund, the super PAC aligned with Speaker Paul Ryan Paul Davis RyanKenosha will be a good bellwether in 2020 At indoor rally, Pence says election runs through Wisconsin Juan Williams: Breaking down the debates MORE (R-Wis.), spent $1.5 million on ads that ran from Sept. 18 to Oct. 9, according to a source tracking the media market. Meanwhile, Democrats’ House Majority PAC will be on the airwaves through Election Day, spending $2.3 million.

And high-profile Republicans and White House officials have barnstormed Sessions’s district, including Vice President Pence, Donald Trump Jr. Don John Trump'Tiger King' star Joe Exotic requests pardon from Trump: 'Be my hero please' Zaid Jilani discusses Trump's move to cancel racial sensitivity training at federal agencies Trump International Hotel in Vancouver closes permanently MORE and Trump attorney Rudy Giuliani.

Trump has not traveled to the district that narrowly rejected him in 2016. But he’s tweeted an endorsement of Sessions twice and name-checked him at a massive campaign rally in Houston on Monday where he claimed the GOP congressman is “still leading” Allred.

The north Dallas district has greatly shifted since Sessions started representing the seat when it was created after the 2000 census. The demographics have changed, with more African-Americans and Hispanics moving to the district. Dallas has seen economic growth, with more tech companies coming in and more businesses relocating headquarters.

Still, strategists say it’ll be challenging to unseat Sessions, who’s served the district since its creation in 2003. Texas Republicans said he took his challenger seriously from the start, which is why many believe he can withstand strong headwinds this cycle.

And Sessions is attempting to tailor his message to focus on the growing economy, which he argues has been bolstered by the GOP’s tax law, while going on the attack against Democrats on immigration — a red meat issue meant to drive out the base.

At a Sunday debate, both candidates sparred over immigration, exposing divisions over a caravan of 7,500 migrants fleeing violence from Central America as they make their way to the southern border.

Sessions said those migrants are “attempting to take advantage of a law that would allow them to come and literally walk across the border.” But Allred slammed the current immigration system, arguing that there needs to be due process for people who have “credible fear for their life” and allowances for them to apply for refugee status.

Republicans are hopeful that Sessions’s diligent focus on these types of issues and his campaigning will allow him to prevail, despite the relentless attacks over pre-existing conditions from Allred.

“Pete raised the alarm about his race almost a year ago when he got a substantive opponent,” said George Seay, former Texas chairman of Sen. Marco Rubio Marco Antonio RubioGOP lawmakers distance themselves from Trump comments on transfer of power McConnell pushes back on Trump: 'There will be an orderly transition' Graham vows GOP will accept election results after Trump comments MORE’s 2016 (R-Fla.) presidential campaign.

“He’s gone up on the air and has very effective spots that I think are comparable to Cruz spots. He’s trying to run the same kind of campaign: ‘My opponent is too left of center.’ I think he’ll pull it out because of that,” he said.