House Minority Leader Nancy Pelosi predicted Thursday that Obamacare will be a winning issue for her party in congressional elections this year, despite a high-profile loss in Florida and hang-wringing among her fellow Democrats.

Marking Sunday’s upcoming fourth anniversary of the Affordable Care Act’s passage, Mrs. Pelosi doubled down on the overhaul and attacked conservative critics whom she said were paying for false ads tarnishing the law.

“I believe it’s a winner,” the California Democrat said.

Her no-surrender position, however, is at odds with that of some of her own troops who, despite the Democratic refusals in the Senate, have voted for many of the House-passed tweaks to major changes in the health law. Other Democratic dissent comes from vulnerable senators seeking re-election in conservative states.

Their anxiety ratcheted up this month when Republican David Jolly defeated Democrat Alex Sink in a special congressional election in Florida. It was considered the first Obamacare test case ahead of the 2014 mid-term elections, though Mrs. Pelosi dismissed the results at her weekly press conference on Thursday.

“With all the money spent, with all the criticism of the Affordable Care Act and a 13-point advantage Republican district, we got it down to below 2 points,” she said.

November will mark the third federal election since the law passed — but the first since most of the provisions became active, including the individual mandate and the health exchanges.

Faced with horror stories of lost coverage and troublesome enrollments back home, Democratic candidates are trying to buoy their prospects by smoothing out the most painful aspects of the law.

In Louisiana, Sen. Mary Landrieu’s campaign is taking credit for changes the Obama administration announced that let people temporarily keep plans that do not comply with Obamacare’s coverage requirements.

Other Democrats are hoping to get Republicans to swear off outside money in order to blunt anti-Obamacare attacks.

In New Hampshire, Sen. Jeanne Shaheen, the Democratic incumbent, has called on potential opponent, former Sen. Scott Brown, to resist third-party campaign dollars, which Democrat leaders have pinpointed as the source of anti-Obamacare propaganda.

Indeed, Democratic leaders think they have a campaign-season bogeyman in the Koch brothers, a pair of energy tycoons who have pumped millions into conservative causes and anti-Obamacare ads, though they also have funded Democrats and are far from the largest campaign spenders on either side of the aisle.

“You have a huge amount of money being dumped into these congressional races by these outside independent groups that are totally distorting the facts and misleading voters,” said Rep. Chris Van Hollen, Maryland Democrat.

Jim Manley, a Democratic strategist and former spokesman for Senate Majority Leader Harry Reid of Nevada, said the new assault on the wealthy donors should resonate with key Democratic constituencies.

“You need an enemy, you need a contrast,” he said, “and the Koch brothers provide it.”

More broadly, he said “it’s awfully hard for Democrats to run away from Obamacare at this point in time,” but each candidate will have to forge his own strategy based on their constituencies.

But Senate Democrats are hoping to stay in voters’ good graces through votes on their own legislative fixes to the law. A spokesman for Mrs. Landrieu said she would still like to see the Senate vote on a bill she crafted to let Americans keep, for as long as they like, the bare-bones health plans they had prior to 2014.

The administration this month decided to let people renew policies that do not comply with the health-care law for an additional two years, a move that Mrs. Landrieu deemed “a good start.”

In the House, Mrs. Pelosi said any attempts to roll back the law are misguided, citing polling that suggests most Americans want the law to be improved, not repealed, and arguing that more than 10 million people have acquired private health plans, put onto Medicaid, or been able to stay on their parents’ plans through the law.

“We can talk about who says what,” she said, “but the facts will speak for themselves.”

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