When Sen. Joe Manchin III, West Virginia Democrat, voted last week to block a Republican attempt to repeal the 2010 health care law, his action on some levels was routine. The vote was straight along party lines, and the GOP effort was viewed largely as a symbolic gesture with little chance of success.
Within hours, however, the Republican public relations machine cranked into action, firing up press releases, videos and a website that attacked the newly minted senator for his vote and support of "the Obama agenda."
"Despite his many campaign promises as he sought West Virginia's Senate seat, Manchin has used his time in Washington to embrace President Obama's liberal policies," Brian Walsh, a spokesman with the Senate Republican's campaign arm, said in an e-mail to reporters the morning after Wednesday's vote on repeal of the health care law.
Although the next congressional elections are more than 18 months away, the vote served as the opening salvo of the 2012 Senate campaigns. Republicans vow to continue to hold Democrats accountable for their support of the measure.
"Those were difficult votes" for moderate Democrats, said Steve Lombardo, a Republican pollster and president of the Lombardo Consulting Group. "The [Democratic leaders in the Senate] needed their votes, and they got them. But now they'll pay some political price."
Mr. Manchin, elected in November to fill the seat of the late Sen. Robert C. Byrd, a Democrat, isn't the only moderate Democrat up for re-election in 2012 who could face a Republican-induced backlash for support of the president's health care initiative. Other likely targets include Sens. Ben Nelson of Nebraska, Bill Nelson of Florida, Claire McCaskill of Missouri and Jon Tester of Montana.
Ben Nelson, in particular, has been hammered by Republicans since his initial support of the measure in late 2009.
Mr. Nelson, like many other moderate Democrats, said he doesn't support scrapping the entire law but would consider tweaking or even repealing some of its provisions, including the "individual mandate" that will require most Americans to have health insurance or risk a penalty.
Mr. Nelson's tactic could be enough to placate voters and keep them in office, especially if public concerns about the law fade over time, some political specialists say.
The law "is not wildly unpopular," said John Fortier, a congressional analyst with the American Enterprise Institute, a conservative-leaning think tank. "It's just unpopular enough for Democrats in swing districts, but it's not unpopular for 90 percent of them, so its not like the whole party has to fear" supporting it.
Other issues are likely to push aside health care reform as a signature issue of the 2012 elections, Mr. Lombardo said.
"No two campaigns are alike," he said. "I would suspect that the next cycle is going to have its own set of characteristics that are going to differentiate from 2010."
But with legal challenges to the law - with an expected last stop at the Supreme Court - the repeal debate will linger, said Sarah A. Binder, a congressional analyst with the Brookings Institution, a moderate Washington think tank.
"This is an issue that's not going away," she said. "And Republicans, for both policy and political reasons, think that it's one of their hooks to building and regaining a [Senate] majority."
Overplaying the health care card presents risks for both parties. Republicans hope the issue still will be relevant with voters by November 2012. Democrats are banking that the public soon will warm to the bill's many reforms.
"There is a gamble going on with both sides here," Ms. Bender said. "Democrats have made the decision that caving on total repeal is not worth it; electorally, the cost of doing that is probably too high."
Mr. Lombardo said Republicans in Congress stand to gain some short-term tactical advantage by forcing votes on the issue.
"That may end up being smart, especially when large segments of independent voters oppose the health care legislation," he said.
But Mr. Lombardo also warned that too much harping from Republicans could obscure broader party themes such as improving the economy, creating jobs and lowering the national deficit.
"If the health care repeal law becomes the definition of this Congress, the defining element of this Congress, I think that's problematic" for Republicans, he said. "If they don't begin to demonstrate that they're going to listen to voters in doing things on the economy, it has the potential to backfire."
As for Mr. Manchin, his moderate polices and frequent criticism of the Obama administration during his 2010 Senate campaign - most notably his opposition to "cap-and-trade" emissions trading proposals that are unpopular in coal-friendly West Virginia - may protect him from Republican attacks, Mr. Fortier said.
"You got to think that in some ways he's inoculated himself against this," he said. "He's just ran in a Republican year and won convincingly, and he certainly has staked out he's more to the right than others who have run in other years."
Democrats likely will have more opportunities to solidify their positions on health care reform, as GOP leaders in the House and Senate have vowed to force more votes to amend or repeal the law.
"This is just the beginning," Senate Minority Leader Mitch McConnell, Kentucky Republican, said minutes after his party lost its attempt to repeal the law. "This issue is still ahead of us and we will be going back at it in a variety of ways."
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