By Ryan Teague Beckwith
Updated: May 24, 2017 2:30 PM ET

After the presidential election last November, Donald Trump’s campaign manager Kellyanne Conway argued that Hillary Clinton lost because she focused too much on trying to disqualify Trump, instead of speaking to voters’ concerns.

“There’s a difference for voters between what offends you and what affects you,” she said.

That’s a lesson that Democrats seem to have taken to heart in a special election for an open House seat in Montana Thursday. Democratic candidate Rob Quist, a banjo-playing folk singer, has spent the closing days of the campaign talking about how the Republican bill to repeal the Affordable Care Act would affect voters, running ads that talk about protecting people with pre-existing conditions and discussing financial problems he faced after gall-bladder surgery.

House Majority PAC, the principal outside Democratic group focused on House races, chipped in more than $150,000 for last-minute ads that also centered on the Republican health care proposal. And Vermont Sen. Bernie Sanders, who did a whirlwind tour of the state with Quist the final weekend before the election, railed against the bill at their events.

Though grassroots Democrats around the country remain upset by President Trump’s actions, the health care bill is an easier target in Montana, a deeply red state that voted for Trump by 20 points in November. A national poll, meanwhile, found only 21% of voters approved of the Republican bill. Some Democrats argue that the legislation could be the key to turning out their voters in 2018 and beyond.

“There’s nothing more personal than health care to people’s lives, and it’s certainly what’s driving the widespread backlash to Republicans and to Republican candidates that that we’re seeing across the country,” said Tyler Law, national press secretary for the Democratic Congressional Campaign Committee.

It remains to be seen how the fight over the health care bill will play out in 2018. The Senate has barely begun drafting its own version of the bill, which will likely be dramatically different from the House-passed version.

But several factors came together to make the health care legislation the center of attention in the statewide Montana race, starting with the fact that it was being debated as the campaign was heating up.

The subject was also given a boost by Republican candidate Greg Gianforte, a businessman who ran unsuccessfully for governor last year. His campaign declined to answer whether he would have voted for the bill that passed the House earlier this month, but the New York Times revealed he told lobbyists he was “thankful” it had passed—a line Quist zeroed in on.

Timing could also play a role. The Congressional Budget Office is expected to release its final analysis on the House bill on Wednesday, meaning voters will wake up on Election Day to headlines about exactly how many millions of people are projected to lose insurance coverage.

That doesn’t mean Quist will win, however. Gianforte has consistently led in the polls, though the margin has narrowed to single digits. Democratic operatives think they’ll likely lose, but Republicans concede it will be a closer race than would normally be expected.

Even if Quist’s campaign is unsuccessful, then, it will likely be seen as a dry run for coming Democratic attacks over the law.

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