Midland University President Ben Sasse, one of several Republicans running in Nebraska for retiring Sen. Mike Johanns' seat, says he opposes the health-care law but has had to explain previous speeches and writings in which he was less absolute, at one point calling the act "an important first step" in overhauling American health care.
"This goes right to the bigger fight between the ideologues and the pragmatists," said Republican strategist Todd Rehm of Georgia, who isn't affiliated with any of the eight GOP candidates for Chambliss' seat. Candidates who want to capture the divided Republican electorate, he said, "see that you can't compromise on any of it. . . . The moment you start to sound like you're open to any compromise, you've sold out the ideologues."
Indeed, Alexander, McConnell, Kingston and Cassidy all voted against the Affordable Care Act in 2010 and for symbolic repeal proposals since then. Some in the GOP leadership say the intraparty struggle is only about tactics, not the bottom line. Carr insists that's exactly the point.
"Their presumption is that tactics don't matter because the outcome would be the same," he said. "But it wouldn't. There wasn't a single Republican vote that passed the Affordable Care Act, whether we're talking establishment, tea party, moderate, conservative, whatever. . . . So if it's so bad -- and it is -- the question is why did establishment Republicans not fight to defund it?"
Leaders of national conservative groups, which have been key players in recent Senate elections, say the distinction is an important consideration as they decide endorsements.
"I would say that any candidate who is a vocal opponent of that [defunding] strategy would certainly cause us hesitation," said Easton Randall of the FreedomWorks political action committee. "The burden is on them to explain what they would do differently to achieve a goal we all claim to share."
So far, FreedomWorks has endorsed McDaniel over Cochran in Mississippi and Nebraska state Treasurer Shane Osborn over Sasse. The group is watching several other races as well.
The Senate Conservatives Fund, founded by former Sen. Jim DeMint of South Carolina, split with FreedomWorks in Nebraska, siding with Sasse. However, the fund endorsed Maness in Louisiana, Bevin in Kentucky and McDaniel in Mississippi, among others. DeMint now runs the Heritage Foundation, whose political arm also is monitoring several races.
Those groups' recent record is mixed. Democrats are hoping for a repeat of 2010 and 2012 races, where the far-right groups backed less-viable candidates who then lost general elections in Colorado, Nevada, Delaware and Indiana. The same groups, though, also helped elect Lee, Cruz and Marco Rubio in the presidential swing state of Florida.
At FreedomWorks, PAC treasurer and policy chief Dean Clancy dismissed any notion that his efforts would hurt the party.
"Republicans make a mistake when they try to waffle on these issues or sound like Democrat-lite," he said.