When the now-famous Guardian reporter Ben Jacobs approached the now-infamous Greg Gianforte on Wednesday night, he had a specific question he wanted to pose to the Republican candidate for Montana’s open House seat. It was about health care.

Jacobs had been following the race closely and knew that Democrat Rob Quist, in the race’s final stretch, put health care at the center of his closing argument.

In March, early in the campaign, the Billings Gazette set the tone for the race with a close look at Quist’s troubled finances over the years. Montanans may have assumed Quist, a legendary local musician and a rancher, was well off, but his music career never brought him that kind of money. He had been the opening act to the Grateful Dead many times — but never the Grateful Dead.

He told the Gazette that gall bladder surgery gone wrong had derailed his music career and set in motion the string of financial setbacks. The day before the Gazette story ran, House Republicans in Washington had decided to pull their repeal-and-replace bill from the floor, aware they didn’t have the votes to pass it. The problem wasn’t just that support was anemic in Congress. The bill had the backing of just 17 percent of Americans, and GOP leadership appeared happy to move on. “Sorry that didn’t work out,” said Senate Majority Leader Mitch McConnell, R-Ky., in his best effort to pretend he was mourning the demise of the politically toxic legislation.

But a klatch of House Republicans insisted on bringing the thing back to life. And in Montana, Gianforte decided it would be a wise move to attack Quist on health care. The conservative outlets PJ Media and the Washington Free Beacon dug into a lawsuit Quist filed after the botched surgery and dug out an unusual nugget they saw fit to share with the world: Quist had genital herpes.

The Republican National Committee promptly forwarded the breaking news around to national reporters. On what possible ethical grounds could a journalist — or anyone, for that matter — decide that publicizing (in the headline, no less) a person’s genital herpes was an acceptable thing to do? Let PJ Media explain:

Normally, medical records should be kept private. But given Quist’s history of default on debt and taxes, and his use of the 1992 surgery to excuse it, the case is a legitimate issue, especially as the candidate slams health care as a major issue.

Early in his red-state race, Quist’s campaign strategy was dominated by ads showing him firing off a weapon at a television. But in the wake of the attacks on his gallbladder surgery-related debts, Quist decided to lean into the issue of pre-existing conditions. That’s when the race got real. “Russia is on TV all day long and it’s what people in Washington are hyperventilating about, but health care is what’s on people’s minds and what they care about, because it’s personal,” said a Democratic source connected to the Quist campaign. “The outside spending was 10-1 on the Republican side, and as soon as the race turned to health care — and Quist owned that — that’s when the race started to tighten.”

This wasn’t a race that was supposed to be close. While Democrats have managed to win at the statewide level in Senate and gubernatorial elections, the lone House seat has proven elusive for two decades. Ryan Zinke won re-election in 2016 by 16 points, with Trump carrying the state by 20 points — and with Libertarian Gary Johnson picking up another 5.6. Just 35 percent of the state voted for Hillary Clinton. A close race spells trouble for Republicans in 2018. “A 4-8 point win for Gianforte would fall somewhere between a pretty good/very good political environment for Dems,” offered the forecasters at FiveThirtyEight.

Quist’s closing ad focused on the issue, noting that more than half of Montanans have pre-existing conditions. The weekend before the election, he crisscrossed the state with Vermont Sen. Bernie Sanders, with both Sanders and Quist telling voters that health care is a right, not a privilege, advocating for Medicare for All. An ad from the Super PAC tied to House Democrats ran one attacking Gianforte on his waffling stance.

The Republican Party couldn’t have chosen a worse man to make its case. Gianforte, a New Jersey businessman, had moved to Montana to expand his firm, which made software making it easier for U.S. companies to offshore jobs.

Worth more than $300 million, according to his campaign disclosures, he was never clear where he stood on the issue of health insurance. He said publicly that he was against the House repeal-and-replace bill, but after the House passed it, he told a conference call full of lobbyists he was “thankful” it had gone through. The bill would have saved him hundreds of thousands of dollars in taxes per year — enough in a year to solve Quist’s financial woes for the rest of his life.

That health care could move votes in this race — even if not enough to swing it — wouldn’t surprise Geoff Garin at Hart Research Associates. His firm recently finished a national survey, which was provided to The Intercept, showing that health care is now voters’ top concern — with 55 percent of independents citing it as the most important priority. Overall, it outpaces the second-place finisher, the economy, by 21 points.