For nearly seven years, Republicans have run — and won — on the campaign promise to get rid of the 2010 health care law.

But now that House Republicans are on record on their own replacement plan, that unifying offensive message has faded, especially since some of their most vulnerable incumbents are at odds with leadership and the White House on what’s being touted as the party’s first major legislative victory this Congress.

Regardless of how the bill changes in the Senate, and who votes for a revised final version, Democrats plan to target all vulnerable Republicans for this vote, not just those who actually supported the bill. GOP leaders knew that, but they took a risk. They reasoned it was better to send the message now that Republicans can deliver on their campaign promises.

“Almost everybody in this conference ran on repeal and replace at some point in their political career,” Oklahoma Rep. Tom Cole said before Thursday’s vote. “And it’s important for most of them to deliver on that promise when they’re given the opportunity to do so.”

But the big question — despite Thursday’s pomp and circumstance, first at the morning GOP conference meeting and later at a rare Rose Garden ceremony for legislation that’s only passed one chamber — is whether this will be a vote the Republican Party comes to regret in 2018.

Going on defense

The partisan script is now flipped: It’s Republicans, not Democrats, who have a plan to defend. And as Democrats know all too well, that’s often a more difficult position to be in when running a campaign.

“It’s true, it’s easier to be against something than for something, especially when it’s a big, complicated issue,” said New York Republican Rep. John J. Faso, who came out in support of the bill after Thursday morning’s conference meeting. That’s a gamble he was willing to make, believing the GOP legislation was better than the status quo.

The bill will undoubtedly change in the Senate, a point to which many House Republicans — even the bill’s more enthusiastic supporters — alluded. They suggested the repeal process had only just begun and that any divisions in the conference may not be reflected in the vote on the final bill.

“It really is important to remember that this bill is a green flag not a checkered flag,” said Indiana Rep. Luke Messer, using a metaphor inspired by his state’s upcoming Indy 500. “The green flag lets the race start; the checkered flag is when the race is over.”

Messer, the chairman of the House Republican Policy Committee, didn’t want to talk about potential implications of his vote in a likely Senate race against Democratic incumbent Joe Donnelly. But it’d be difficult to win any race, he said, without keeping his campaign promises to repeal. 

Cole, a House GOP deputy whip, said he sensed that “members didn’t want to go home again and have to say, ‘I hadn’t been able to get this thing done.’” The House recessed immediately after Thursday’s vote.  

More than three months into the Trump administration and with control of all three branches of government, Republicans needed to show they could govern, said Cole, a former chairman of the National Republican Congressional Committee.

“This is one part of that process — it’s a pivotal moment in that process — but it’s not enough to guarantee success or dictate failure,” he added.

The attacks are already here

Democrats are pouncing on a bill that will likely result in millions more uninsured Americans and in potentially higher costs for people with pre-existing conditions. 

Faso is not worried about that. The New York freshman is likely to face a competitive re-election next year in a district that President Donald Trump carried by single digits. Inside Elections with Nathan L. Gonzales rates his 19th District race Tilts Republican. 

“Pre-existing conditions are covered in this bill. The Democratic argument is false,” Faso said. 

Over and over again this week, Republicans echoed that refrain when asked how they’d respond to Democratic attacks.

“Hopefully, with the truth,” said Iowa Rep. Rod Blum, a Freedom Caucus member who’s also a top Democratic target in a Leans Republican race. Energy and Commerce Chairman Greg Walden had a similar response. “Because it’s not true!” he said, rushing out of the GOP conference meeting Thursday morning.

Rep. Tom MacArthur is ready to make that case. He wasn’t an obvious candidate to enter talks with the Freedom Caucus. A Democratic target in 2018, he represents a southern New Jersey district that Trump won by single digits. His neighboring GOP colleagues opposed the bill.

“I’m not concerned,” MacArthur said, noting that he’s holding a town hall next week in a town where he only received 10 percent of the vote.

“I will meet my constituents and talk to them, and help them understand that what they hear in the media and what fearmongers are trying to whip up is simply not the truth — that we’ve, in fact, saved the individual health system,” MacArthur said.

That was the sentiment reflected in a new NRCC digital ad released Friday entitled “Promise Made, Promise Kept,” which said it was “time to look out for the American people.” 

The 20 holdouts 

But if the recent past is any indication, political attacks don’t have to be true to work. Again, just ask Democrats, who have suffered their own health care-inflicted losses. 

They greeted the bill’s passage on the floor Thursday afternoon with singing of “Nah, nah, nah, nah, hey, hey, hey, goodbye,” directed at their colleagues across the aisle. If Democratic attacks do resonate, it may not just be Republicans who supported the bill who suffer. In the 2010 midterms, 17 Democrats who opposed the health care law still lost their seats. 

Next year, Democrats need to gain 24 seats to win the majority. The DCCC has already targeted members who voted against the bill, and now Democratic candidates are making the same case. In a statement shortly after the vote, Virginia state Sen. Jennifer Wexton, a top challenger to two-term Rep. Barbara Comstock, said Comstock “is responsible for the actions of her party.” (The congresswoman came out against the bill before the vote.)

Comstock was among four members in the NRCC’s Patriot Program for vulnerable members who voted against the bill. Two of those members who voted “no” were just added to the program on Tuesday. The NRCC promised after the vote to stick by all its members, regardless of how they voted, and said the vote will not affect eligibility for membership in this year’s Primary Patriot Program for dues-paying members facing a credible primary threat. 

Cole predicted that colleagues will continue to write checks to members in the Patriot Program, regardless of how they vote.

“There’s no such thing as an unimportant Republican member,” he said. “I don’t think anybody will have a shortage of help around here.”