WASHINGTON -- In his West Virginia district, the TV ads attacking Democratic Rep. Nick Rahall over the calamitous startup of President Barack Obama's health care law have already begun.
The 19-term veteran, a perennial target in a GOP-shifting state, is among many in the president's party who have recited to constituents Obama's assurance that they could keep insurance coverage they liked under the 2010 overhaul. That has proved untrue for several million Americans, igniting a public uproar that has forced Obama to reverse himself on part of the law and sent many Democrats scrambling into political self-preservation mode ahead of next year's midterm elections.
On Friday, Rahall was among 39 Democrats who, despite an Obama veto threat, voted for a GOP measure that would let insurers continue selling policies to individuals that fall short of the health care law's requirements. It was approved 261-157.
"I'm concerned about my integrity with voters who have returned me here 38 years. They know me enough to know I wouldn't purposely mislead them," Rahall said this week. "They have that confidence in me, and I want them to continue to have that confidence in me."
Republicans are emboldened by Obama's reversal and the Democrats' scramble for cover. They are already compiling lists of dozens of Senate and House Democrats like Rahall who, in video clips and written statements, have parroted Obama's pledge that voters' existing coverage would not be annulled.
"There's nothing more damaging than when your word is devalued and people think they were misled," said Rep. Greg Walden, R-Ore., who heads the National Republican Congressional Committee, the House GOP's campaign arm. "And especially damaging is when it actually affects you and your family. So in terms of degree of impact, this is off the Richter scale."
Top Democrats, who need to gain 17 seats to retake the House majority, scoff that next November's elections are far off. They say by then, the health care law will be to their advantage because it will be working well.
Rep. Steve Israel, D-N.Y., who leads the Democratic Congressional Campaign Committee, said his party will focus the campaign on the economy, Democratic efforts to fix it and the GOP's preference for cutting Medicare and granting tax breaks to the wealthy.
The Republican emphasis on the health care law's problems "from a partisan perspective gins up the Republican base. But it alienates independent and moderate voters," said Israel, who said those voters "are more interested in solutions."
Other Democrats agree that plenty can change in a year but concede that the issue poses problems.
Martin Frost, a former Texas Democratic congressman who headed the House Democratic campaign committee, said many people still may lose their coverage because state officials have ample power over insurers. And he said the Obama administration cannot allow additional foul-ups.
"If I were still in Congress, I'd be concerned," Frost said.
Sensing an edge, the GOP plans to cut commercials featuring Democrats' promises that people could keep their health insurance. They are already emailing press releases to reporters attacking Democrats on the issue.
"With Obamacare proving to be a total disaster -- from the botched website to the broken promises -- it's no surprise that Barber is now desperate to hide his support," said one GOP release distributed in the district of freshman Rep. Ron Barber, D-Ariz.
Republicans are aiming similar attacks against Democrats challenging GOP incumbents, urging reporters to ask them their views on the health care law.
America Rising, a GOP political action committee that compiles research on opposition candidates, is collecting video of Democrats' comments on the law. And some conservative groups are already running television spots, with Americans for Prosperity airing ads attacking Rahall and Sen. Kay Hagan, D-N.C., while defending Rep. Dan Benishek, R-Mich., for opposing the law.
"It forces thousands to lose the plans they love and the doctors they know," says the 30-second spot running on television and radio in Rahall's West Virginia district.
Barber, the Arizona Democrat, also voted for the Republican bill. He said he believes that eventually, people will be able to keep the plans they want and the government's troubled health care website will be fixed.
"If that gets resolved satisfactorily, I think it will be less of an issue than it is today. That's why you have to take the long view," said Barber.
Though Democrats opposed the House GOP bill 153-39, Friday's vote underscored the pressure they feel over canceled policies.
The health care law let insurers cancel some existing coverage that lacked the improved features now required. More than 4 million policyholders have received termination letters from their carriers, according to an Associated Press tally.
Feeling public heat, Obama on Thursday took administrative action to let insurers continue current plans for a year. He took the blame for the confusion, saying, "That's on me," not congressional Democrats. House Democratic leaders told reporters later that day that they had nothing to apologize for.
Even so, most House Democrats felt Obama's action was not enough and demanded a vote on a Democratic proposal.
"They want to be on record," said Rep. Mike Doyle, D-Pa. "Members are not judged by administrative fixes. Members are judged by their voting records."
Top Democrats finally proposed their own plan. But that was not until rank-and-file lawmakers threatened to back the GOP bill, which Democrats said would weaken the law because it would let insurers issue new substandard policies, not just renew old ones.
A similar dynamic is in play in the Senate.
Sen. Mary Landrieu, D-La., backed by colleagues who like her face competitive re-elections next year, has proposed legislation requiring insurers to renew policies canceled because of the law.
Not eager to breathe life into a challenge to the health care overhaul, leaders have not decided whether they will allow a vote on Landrieu's bill.