“I think it’s time for a new generation of leadership in Washington,” said Moulton, an ambitious former Marine Corps officer who represents a district northeast of Boston. “I think it’s time for a new generation of leadership in the Democratic Party, and Amy is exactly that type of leader.”

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The crowd erupted in applause, reflecting a sense of frustration over a party that they believe has become estranged from rural America as coastal liberals like San Francisco’s Pelosi dominate.

As dozens of Democratic candidates have distanced themselves from Pelosi, adding uncertainty to any leadership bid next year, Pelosi has had one response: “Just win, baby.”

Now, on the cusp of victory, she is preparing to make her case to extend a 16-year stint as the top House Democrat — a tenure that included four years as speaker. In that role she delivered a landmark economic stimulus and health-care and financial overhaul legislation. Then came the 2010 electoral wipeout and three more failed campaigns to retake the majority.

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In an interview, Pelosi said she was ready to say she remains the best person for the job.

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“My argument’s been about what needs to be done and who’s the best person to get it done,” she said. “Nobody is indispensable. But I do think that I am best qualified to take us into the future, protect the Affordable Care Act, to do our infrastructure bill and the rest. Stepping down this path, I know the ropes.”

Pelosi has been preparing to take the gavel for months — not only raising millions of dollars and campaigning for candidates, but also fashioning a governing agenda and keeping her party focused on the core issues of health care and economic fairness while steering away from more divisive fights on immigration and a potential Trump impeachment.

Pelosi also laid the groundwork for an argument that could carry special relevance to a crop of incoming lawmakers who have all run on protecting access to affordable health care: Not only is she a key architect of the very legislation they want to protect, she orchestrated the campaign to protect it — one that began in the days after Trump’s election.

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“As soon as he won, we knew that the Affordable Care Act was at risk and that we needed to mobilize and organize to protect it, and we had a plan to do so,” she said, carefully highlighting the efforts of grass-roots activists and outside organizers while also making her own central role clear: “We made our own environment.”

The health-care law could be the key to Pelosi’s redemption.

In March 2010, Pelosi muscled the sweeping bill through the House, rejecting the notion months earlier from Obama administration officials that the party opt for a scaled-back version. “Kiddie care,’’ she dismissively told White House Chief of Staff Rahm Emanuel.

That November, in large part due to the unpopular law, the party suffered a crushing loss of 63 House seats and its majority.

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This year, Pelosi’s singular focus on GOP efforts to weaken the law’s core protection for Americans with preexisting medical conditions could be the defining issue of the election and help Democrats reclaim the majority.

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Pelosi has mostly brushed off her critics inside the party, who have argued that she has long been a political drag on Democratic candidates in potentially winnable districts. Inside the House Democratic Caucus, however, the frustrations have never reached escape velocity, and her allies are once again ready to argue that no one is better equipped to lead.

Rep. Raúl M. Grijalva (D-Ariz.), chairman of the Congressional Progressive Caucus and a Pelosi ally, posed a question new members will face when they get to Washington: “Who could put the foot on the gas and move us?” A restless Democratic base will “want to see movement,” he said, and no one will be ready to move faster than Pelosi.

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But to Moulton and a small group of like-minded Democrats, those kinds of arguments are at best patronizing and at worst insulting to dozens of other House Democrats who have been eager to inject new blood into the leadership only to see the top three septuagenarians — Pelosi, 78, Minority Whip Steny H. Hoyer (Md.), 79, and Assistant Democratic Leader James E. Clyburn (S.C.), 78 — consolidate power even after losing four straight elections.

“It’s about people looking at the Democratic Party and saying, ‘I want to follow you,’ ” Moulton said in an interview after addressing the Kentucky Democrats. “I don’t think people look at our current leadership and say, ‘Oh, there’s the future of the Democratic Party.’ But people in here look at Amy, and they say, ‘That’s the future of the party.’ ”

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McGrath, a former Marine Corps fighter pilot, has aggressively called for a “new generation of leaders.” But she has pointedly not said how she would vote on Pelosi.

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In Kentucky, where Democrats are reeling after having been dominant in state politics for generations, party loyalists share plenty of Pelosi fatigue. Her political baggage has even sifted down into local politics, where one Democratic candidate running for state representative has seen her Republican opponent send mailers featuring Pelosi’s face.

Vic Ferguson, a Paris, Ky., farmer whose daughter Emily was the subject of the mailer, said he feared that Pelosi’s continued tenure could make Kentucky Democrats extinct.

“We might as well just go to the stockyard and just line up in the cattle chutes, and go for the slaughter,” he said. “If that’s her ego that’s keeping her” as leader, he added, “we all sacrifice for that.”

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McGrath said she is primarily frustrated that the party leadership — coastal, long-tenured and just plain old — doesn’t represent the full breadth of the party.

“I mean, the Democratic Party is the party of young people. Young people! But where is our leadership?” she said. “The Republican Party does such a better job of grooming the next generation of Republican leaders. The Democratic Party does not, and I think that we need to change that.”

But what McGrath says next is exactly what Pelosi and her allies are counting on — that, when it comes time to vote for a speaker, she would probably support a Democrat who might not be her first choice over a Republican.

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“I want to do what’s right for the country,” she said. “So if it’s between somebody here, and, you know, a Paul Ryan, who I think has been a disaster, I can tell you who I’m not voting for.”

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Moulton said there’s “no litmus test” on party leadership for any candidate receiving his support, but the candidates supported by his Serve America PAC and a related joint fundraising committee are among the most vocal about changing party leadership. Most of them, however, are in tougher races than McGrath’s, and the sort of Democratic wave that would elect them could also bolster Pelosi’s case for the speakership.

And while a handful of House Democrats — including Moulton, Rep. Kathleen Rice (D-N.Y.) and Rep. Tim Ryan (D-Ohio) — have been outspoken in seeking to upend the party leadership, none is actually seeking to challenge Pelosi or any other party leader. Moulton, who has openly floated a 2020 presidential run, insists he is not running for anything except his own reelection.

Ryan, who ran unsuccessfully against Pelosi in 2016, hinted he would consider another run in a Sunday Fox News Channel interview, saying the party leadership elections “will not be a coronation.”

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Moulton said plenty of candidates will emerge once it becomes clear that Pelosi can’t win the 218 floor votes she will need to become speaker. And, he argues, she will be vulnerable even if, perhaps especially if, there is a Democratic wave.

“For our party to respond [to a wave] by saying . . . we’re going to reinstall the exact same status-quo leadership that you voted out many years ago, it’s just shooting ourselves in the foot,” he said. “It guarantees a two-year majority.”

Meanwhile, Pelosi has spent the past month staying far above party infighting — crisscrossing the country for Democratic candidates willing to stump with her, predicting victory in a late-night TV interview — and reminding Democrats why Republicans spend so much money attacking her.