The GOP bets that voters' displeasure will intensify in 2014 as more provisions take hold. Besides exchanges and Medicaid enlargement, businesses with at least 50 full-time employees will have to provide insurance coverage and state insurance regulators will enforce coverage minimums. Many market analysts predict premium increases for individual policies.
"It's not accidental that President Obama scheduled the most popular provisions to be in effect for his election year," argued Brad Dayspring, a spokesman for the national GOP's Senate campaign arm. "He's left a lot of 2014 Democrats hanging out to dry with the unpopular provisions."
Democrats say Republicans need Obama's health care overhaul only to rally their core supporters, who are particularly important in midterm elections in which the electorate typically is older, whiter and more conservative.
Dayspring said the issue wins independents.
John Anzalone, a Democratic campaign consultant and pollster, retorted: "What happens when the boogeyman that's promised never comes?"
Anzalone, who counts Hagan among his politician clients, said the best counter for vulnerable Democratic incumbents is to use their office actively to help constituents take advantage of the law. House Democratic leader Nancy Pelosi outlined the same approach in a 78-page memo to her caucus members last month.
Democrats also argue that Republicans ignore their own vulnerabilities and individual state dynamics that could complicate a GOP effort to run a national campaign.
The law, Begich notes, established long-term coverage plans for Native Americans. "That's important to Alaska" and lingered in Congress for two decades before finding a place in the act, he said.
Landrieu can point to bonus payments she negotiated for Louisiana's Medicaid program to make up for money lost because of several hurricanes. Conservative commentators mocked the arrangement as the "Louisiana Purchase," but Jindal, who asked for the extra money, gladly used it to balance Louisiana's budget in multiple fiscal years.