Only a few months after the heated battles on Capitol Hill, it must have been quite a relief for President Obama to turn his focus to health care reform, however briefly, last week. After being pummeled by Republicans and cable talking heads over his response to the Gulf oil spill, spending a full hour talking to seniors about Medicare had to feel positively relaxing.

The town-hall meeting held June 8 included audiences in 100 locations across the country, connected via conference call to a senior center in Maryland where Obama and Health and Human Services Secretary Kathleen Sebelius fielded questions about how the new health care law will affect their benefits. Topics ranged from cuts to the private insurance program Medicare Advantage to why the federal government can't move faster to close the Medicare Part D "doughnut hole," a gap in prescription-drug coverage that will be gradually bridged over the next 10 years. "I'll be honest with you: it's just a matter of money. It's very expensive to close this doughnut hole," said Obama. "For us to close that right away would have blown a hole through the budget." (See what health care reform means for you.)

As with any presidential gathering, this supposed policy event was as much about politics. It was in fact just one blip in a vast Administration-orchestrated campaign now ramping up to tout changes to the U.S. health care system brought on by the Affordable Care Act. On June 7, the White House also announced $51 million in grants for states to beef up health-insurance regulation and a new push to combat Medicare fraud. On June 10, a round of $250 rebate checks was sent to those seniors stuck in the doughnut hole. And also on June 10, the Democratic National Committee began airing a one-minute television ad called "We Can't Afford to Go Back," highlighting popular portions of the Affordable Care Act and charging Republican critics with obstructionism. (See a timeline of when health care reform will roll out.)

All this activity, not surprisingly, is being launched during the run-up to the fall midterm election campaign, in which health care reform is expected to remain a contentious issue. One outside group reportedly headed former White House communications director Anita Dunn and Democratic strategist Andrew Grossman is launching a multimillion health reform advocacy campaign to tout the new law and help congressional candidates respond to political attacks this fall.

Obama pollster Joel Benenson said in a recent memo that he believes there's a new opening for Democratic candidates to highlight the benefits of health reform. Contending that Republican efforts to bash or repeal the new law "could lead to a backlash if their rhetoric against reforms becomes too strident," Benenson said voters are "slowly becoming increasingly comfortable with the law." He cites a recent NBC–Wall Street Journal poll showing that 55% of Americans are more likely to support a candidate who backs the new law.

The latest tracking poll from the nonpartisan health care think tank the Kaiser Family Foundation, however, shows just 29% of Americans think they would be "better off" under the Affordable Care Act, compared to 42% who believed that in November. So perhaps it's not surprising that some Democrats running for Congress would just focus their campaigns on the economy, the environment, immigration and a host of other issues that have eclipsed health care in recent months. With the memories of last summer's heated antireform town halls still seared in many reps' memories, the New York Times reported last week that "it was no accident" that most House Democrats chose not to hold town halls during their recent Memorial Day break.

Vulnerable pro-reform House Democrats have to walk a fine line this fall. They must tout the popular immediate benefits of the Affordable Care Act — like the $250 doughnut hole checks — while avoiding too many mentions of "Obamacare" and focusing the bulk of their campaigns elsewhere.

In at least one race, for North Dakota's lone congressional seat, health care reform already looks to be a clear liability for Democratic incumbent Earl Pomeroy. An outside group, Americans for Prosperity, is funding a sinister-sounding television ad saying, "Earl Pomeroy ignored us and voted with Nancy Pelosi for Big Government health care." A recent Rasmussen poll has Republican challenger Nick Berg leading Pomeroy, and well-regarded race watcher Charlie Cook has the race one step away from a "toss-up," at "lean Democratic." (Pomeroy has held the seat since 1992.) The three television ads highlighted on Pomeroy's website don't mention health care at all, but instead attempt to distance the candidate from Washington politics. One ad advertises Pomeroy's opposition to cap-and-trade legislation, supported by many Democrats in Congress, and another bills him as an outsider. "We're a long ways from Washington out here — just the way we like it," he says.

Democrat Betsy Markey, a freshman member of Congress representing a district in northeast Colorado, had voted against the original House health reform bill. After she changed sides and backed the final measure, Republicans broadcast cries of "Bye-bye, Betsy," saying she was sure to be voted out in this fall's election. Sarah Palin designated Markey as one of 20 Democratic seats on her "target" list for their health care votes. Supporters, however, have rallied behind Markey; she raised more than $350,000 in the weeks after landing on Palin's list and her campaign to highlight benefits of the new law has mirrored the Administration's. She sent out a press release announcing the $250 Medicare rebate checks, for instance, and has benefited from television ads paid for by unions and the Democratic National Committee.

Markey's tough position was noted by Obama the night before the House passed the health care reform bill in March, when the President addressed the Democratic caucus. "Betsy is in a tough district," he said. "I am actually confident that [voting for the bill] will end up being the smart thing to do politically. I am convinced that when you go out there and you are standing tall and you are saying, 'I believe that this is the right thing to do for my constituents and the right thing to do for America,' that ultimately the truth will win out."

Those opposed to Democratic health reform still see the issue as a political winner, White House p.r. efforts notwithstanding. House minority leader John Boehner sent out a press release about the newly energized Administration messaging campaign titled "All that Glitters Is Not Sold," and James Capretta, a former White House staffer during the George W. Bush Administration, is spearheading a website touted by conservative Bill Kristol to counter pro–health care reform messages. Called ObamaCareWatch.org, the site includes commentary and reporting critical of the Affordable Care Act. The opening piece on the website is headlined, "The More We Learn, the Worse It Gets."

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