But the laser focus on the issue from Londrigan and other Democratic candidates represents a major shift in strategy from the party’s approach in 2016, when, many in the party say, it wasted time attempting to punish Trump over every controversy or breach of decorum — only to lose the White House while failing to take back the House or Senate.

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This time, Democrats are determined not to repeat that mistake. Instead, they are staying focused on their issues, especially health care, where they have a clear distinction to draw with Republicans.

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Trump continually commandeers national chyrons and headlines, telling audiences that the election will be about newly confirmed Supreme Court Justice Brett M. Kavanaugh and the migrant caravan making its way north through Mexico. H e declared at a rally in Mississippi last month, “I am on the ticket, because this is also a referendum about me.” But Londrigan and Davis say the national shouting match feels remote in discussions with their district’s voters, who both candidates say are more apt to ask about health care and other pocketbook issues than about Trump’s latest controversy.

Health care is “at the top of their minds,” Londrigan, 47, said in an interview this week hours before her fourth and final debate against Davis, during which health care would again be the dominant topic. “And people don’t want to go back to the Dark Ages. They don’t want to go back to a time when they put caps back on, when people who have preexisting conditions either can’t get coverage or can’t afford it. And they know what’s at risk.”

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Polls show that health care is a top issue for voters and that voters trust Democrats over Republicans to handle the issue.

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Democrats’ eagerness to talk about it represents a striking turnaround from the past several election cycles, when Republicans attacked them relentlessly and effectively for passing the Affordable Care Act and vowed to repeal it. Now Democrats are on the attack, and Republicans such as Davis are on defense, forced to explain their multiple Obamacare repeal votes and insist they truly do want to protect people with preexisting conditions.

Democratic leaders have instructed candidates repeatedly to press their advantage on health care and not get drawn into chasing the latest Trump controversy, because that would be time spent not talking about health care or other issues that affect voters’ daily lives.

“Democrats learned from 2016 that going all in against Donald Trump is a risky strategy, because his popularity varies widely depending on the district and depending on the state,” said Nathan Gonzales, editor of Inside Elections, a nonpartisan newsletter that tracks congressional races. “But health care gives Democrats an opportunity to talk about individual Republican members’ records.”

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Gonzales added, “President Trump and Republicans in Congress have done the unthinkable and gotten Democrats to defend the Affordable Care Act.”

Londrigan remains the underdog in the race. Trump beat Democratic presidential contender Hillary Clinton here by five percentage points, and Davis won reelection in 2016 with 60 percent of the vote. He was first elected in 2012 in a tight contest, even though the district was drawn to help Democrats.

But early-vote numbers in the district show intense interest in the race compared with 2014, and Londrigan hopes to win by being the poster child for Democrats’ forget-Trump-and-focus-on-health-care strategy.

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Davis insists last year’s House GOP repeal-and-replace bill protected coverage for people with preexisting conditions, pointing to language in the bill that stated “nothing in this act shall be construed as permitting health insurance issuers to limit access to health coverage for individuals with preexisting conditions.”

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But nonpartisan analyses of the legislation and numerous fact checks have concluded that the GOP bill could make coverage significantly more expensive for people with preexisting conditions.

Davis is attacking fact-checkers, claiming they are politically motivated.

“It’s very upsetting and frustrating to me to be accused of not wanting to protect preexisting-condition coverage when we put those protections in our bill,” Davis said in an interview in Springfield after participating in a discussion at a medical center about virtual colonoscopy technology with his wife, Shannon, a 19-year survivor of colon cancer.

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“There’s no question that it is pretty disappointing to me, and frustrating, when you have supposed independent fact-checkers saying what our intent was with language that was pretty clear,” Davis said. “That is something that I haven’t experienced in politics before.”

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For some voters in the 13th District, which sprawls down central Illinois taking in the state capital of Springfield and a half-dozen colleges and universities, including Normal’s Illinois State University, the debate is anything but theoretical.

Brianne Murphy, 23, an ISU graduate who works at a record store in Normal, said she has a preexisting condition, fibromyalgia, and is concerned about insurance becoming unaffordable for her once she turns 26 and can no longer be covered on her parents’ health plan. Partly as a result, she said, she is supporting Londrigan.

“That’s my biggest concern,” Murphy said, “that when I’m kicked off I don’t want it to be extremely expensive.”

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Kelly Murphy, 54, described herself as a newcomer to town who moved for a job with insurance benefits after her previous attempts to self-insure through the ACA exchange marketplaces became unaffordable.

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“I think that Obamacare had a good idea, but they missed the whole boat,” Murphy said, adding she was not sure who she would be voting for in the congressional race, because she had not yet educated herself.

Both candidates will be trying to close the deal with undecided voters such as Murphy in the final days of a campaign that has seen a gusher of outside money, more than $2 million on each side by some estimates.

Londrigan, a Springfield native and mother of three who spent her career working in nonprofit fundraising, has made her personal health-care story central to her campaign. Nine years ago, her then-12-year-old son, Jack, was bitten by a tick and ultimately developed Rocky Mountain spotted fever and sepsis, bringing him near death.

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Londrigan credits her sons’ doctors in Springfield with saving his life. She also describes the realization that had her family not had good insurance at the time, they could have gone bankrupt from the bills.

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“When I share our personal story, you can almost see the walls coming down in people’s minds, because they’re thinking about their own family, or their best friend,” she said. “And it cuts across every line there is.”

But Davis, 48, disputes that the issue has put him on defense or forced him to compete on Democratic-friendly terrain, saying that he has always made health care a focus and that he, too, has a personal story to tell because of his wife’s brush with cancer. He says that Londrigan’s focus on the issue has allowed him to tell and retell it.

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“That allows me to tell the story about how my family is no different than hundreds of thousands of families in my district that have experienced the same thing,” Davis said. “And I think that makes me able to relate more, rather than be just a member of Congress that . . . because we go to D.C. we could easily get turned into a political caricature.”

Nationally, Republicans have worked to recast their long campaign against the ACA, insisting that they never had a problem with the preexisting-conditions rules, only most of the rest of the law.

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In Ohio, Republican gubernatorial nominee Mike DeWine declined to join a lawsuit by other state attorneys general that would scrap most of the ACA. In one ad, he hits Democratic nominee Richard Cordray for never having voted to protect preexisting conditions . Cordray has never held a legislative office in which he could have voted up or down on the rules.

In Wisconsin, Democratic gubernatorial challenger Tony Evers has attacked Gov. Scott Walker (R-Wis.) for joining the lawsuit. Walker, meanwhile, promised to call a special session of the legislature if the ACA were overturned in court — but Republican legislative leaders said that a bill re-implementing the ACA’s most popular rules might not have the votes to pass.

Although Democrats predicted from the outset that the ACA would one day become popular, some seem pleasantly surprised that it is drawing more support after disastrous election cycles that began with them losing the House in 2010. Rep. Cheri Bustos (D-Ill.) said that with health care on an unsustainable trajectory, Democrats did the responsible thing in passing the ACA.