To Needham, there was only one way to look at the matter. “What’s the point in having a conservative party if we’re not going to fight a massive federal intervention in health care?” he told me. “It’s one-sixth of our economy!”

Needham and Chapman knew there were risks in allying themselves with King, an inveterate bomb-thrower with a deep yearning for the spotlight. But King was also a tenacious conservative. On June 16, he introduced his discharge petition, and Heritage Action began sending out emails to the foundation’s 661,000 members, urging them to pressure representatives on both sides of the aisle to sign it — ominously adding in a news release that “those who fail to support this effort are responsible for Obamacare.” The petition soon picked up two highly influential signatories: Representative Tom Price of Georgia, an orthopedic surgeon who was chairman of the Republican Study Committee, the House’s internal conservative think tank; and Representative Mike Pence of Indiana, a staunch conservative and personal hero of Needham’s who refused to vote for Bush’s Medicare bill in 2003.

A month later, Heritage Action turned up the heat on the 34 Democrats — most of them so-called conservative Blue Dogs — who voted against Obamacare in March but had yet to sign King’s discharge petition. In a press statement, Needham declared, “I know their constituents, who will be attending town halls this August, are eager to hear why they do not support the repeal effort.” In September, a single Democrat, Gene Taylor of Mississippi, added his signature. The tally reached 173, well short of what it would take for King’s bill to make it to the House floor — much less to get it passed and then sent over to the Senate, where Republicans’ appetite for abolishing Obamacare altogether was less acute than it was in the House.

But though the discharge petition had stalled, King and Heritage Action could justifiably declare a victory of principle and, eventually, an I-told-you-so. Overall, those who pledged fealty to repealing Obamacare fared better that November than those who didn’t. As King told me recently: “The Barry Jacksons and the John Cornyns were clearly wrong. Look at what happened to the Blue Dogs in 2010. There were 53 of them when Obamacare passed. Now I don’t know if you can count three of them.” King was exaggerating, but not by much — there are 18 members of Congress’s Blue Dog Coalition today. “Pelosi made them walk the plank, and they fell like tenpins after that. Since then, I don’t think there’s been a freshman Republican who didn’t run on the full repeal of Obamacare.”

Bashing Obamacare instantly became a winning Republican message — an indictment of its polarizing namesake, of big-spending Democrats and of the boogeyman of creeping socialism all rolled into one. During the 2010 midterm election cycle, opponents of the A.C.A. spent $108 million on ads pillorying it. As a reward to the 87 Republican freshmen whose victories had enabled the party to retake the House, Eric Cantor devoted part of his first day as the House majority leader to introducing H.R. 2, the “Repealing the Job-Killing Health Care Law Act.” It would become the first of more than 50 bills that would pass the House over the ensuing four years designed to repeal, defund, restrict or delay implementation of Obamacare. None of them stood any chance of becoming a law — they were dead on arrival in the Democratic-controlled Senate. But to Heritage Action, they served a purpose: in the organization’s parlance, to “lock in” members, to “orient” the Republican Party to conservative principles so that it would “do the right thing.”

At times, however, what looked like the “right thing” was, from Needham’s vantage, in fact the wrong thing. In April 2011, for example, a bill dismantling part of Obamacare did clear the House and then the Senate, and was signed into law by President Obama without hesitation. It was a measure to eliminate the requirement that small companies submit 1099 forms for all transactions exceeding $600, which essentially served as a tax to help pay for the program and which Heritage Action had condemned as “burdensome” and “onerous,” guaranteed to generate paperwork and high accounting fees.

But Heritage Action, because of its ironclad resistance to “partial repeal,” actually opposed the measure to get rid of the 1099 provision. Yes, it would help small businesses — but then those same small businesses would no longer care to be part of Heritage Action’s crusade. As Needham later told me, “We felt that when anything less than full repeal becomes acceptable, you open the door for every lobbyist in town to say: ‘Hey, while we’re working on full repeal, let’s fix the 1099 issue. Or let’s fix the franchise-restaurant issue’ ” — the popular shorthand for an A.C.A. provision requiring companies with 50 or more employees to provide health care to anyone working over 30 hours a week. “You eventually over time whittle off various constituencies that we want to keep as part of the full-repeal platform.” Partial repeal would be well and good if it got rid of what Needham called a “vital organ” of the law: the individual mandate, say, or Medicaid expansion. But “those vital organs were never going to go down if repeal was defined by Washington’s lobbying class. It would be 1099s and these heavily lobbied issues, and then we’ll be stuck with Obamacare.”