Republican Rep. Scott DesJarlais is in trouble. Big trouble.

Whether that trouble catches up with the freshman Member, a physician, on Tuesday or whether it’s his undoing during the 2014 primary season, he’s unlikely to make a career of being a Congressman in Tennessee’s conservative 4th district.

“Religious faith is far more important to voters than party,” one Tennessee GOP operative said, “so lifestyle is going to matter a great deal to voters in both parties there.”

In 2000, DesJarlais pressured a woman — a patient — with whom he was having an extramarital affair to get an abortion, according to a story first reported by the Huffington Post in early October. Then, on Sunday, the Chattanooga Times Free Press ran a story about another patient who said she had a sexual relationship with DesJarlais. The woman, who was unnamed, claimed that she smoked marijuana with DesJarlais and that he prescribed her “pain medication on dates at his home,” according to the newspaper.

“The Chattanooga Times Free Press is reporting a factually inaccurate story from a noncredible anonymous source, who is lying,” DesJarlais said in a statement relayed to Roll Call by his campaign.

Responding to the Huffington Post article, DesJarlais spokesman Robert Jameson didn’t deny the story but knocked it in a statement.

“Our opponent and his far-left allies know they cannot attack the Congressman on his record in Congress and as a result have used gutter politics to try to make this election about a 14-year-old divorce,” Jameson said.

Because the stories broke late and his Democratic opponent, state Sen. Eric Stewart, doesn’t have a lot of money to push the message out throughout the three media markets that cover the reconfigured district, DesJarlais looks like he has a reasonable path to victory next week. Stewart had only $110,000 in the bank on Oct. 17, according to Federal Election Commission filings. The Democratic-aligned House Majority PAC will have spent $280,000 in the 4th district by Election Day, but it is probably too little too late. Insiders said there were signs in much of the district that the story hadn’t broken through. Still, Democrats held out hope.

“I’m very optimistic about the race,” said John Rowley, Stewart’s media consultant. “But the challenge for Stewart is a month ago he didn’t have a lot of money and [President Barack] Obama’s probably going to lose the district by 30 points.”

Stewart’s campaign made the case that there really was a way for him to win.

“Our latest poll showed that this race was a dead heat,” said Katie Hill, communications director for Stewart’s campaign.  She noted that much of the district was new for DesJarlais, whom she called “a do-nothing candidate.”

And she hit DesJarlais on his values.

“At the end of the day, Eric is someone who represents Tennessee values,” she said. “I have trouble believing that Tennessee values include having sex with one patient after another.”

Whatever his values, DesJarlais is a Republican in a district that has a very strong Republican bent — it would have voted
64 percent for Sen. John McCain (R-Ariz.) in the 2008 presidential election. And a big percentage of the population there votes early. That could well lock in a DesJarlais victory before Tuesday.

Assuming he survives Election Day, DesJarlais will have a much steeper hill to climb next cycle.

Four plugged-in Tennessee Republican insiders told Roll Call that it didn’t look like DesJarlais would make it through the 2014 primary cycle.

“Does he run again? Does he get dug in? Does he get bullied out?” one Tennessee Republican consultant wondered. “That’s going to be an interesting story from 15 seconds after the polls close.”

Indeed, there are already Republican names being floated by insiders as potential primary challengers, including state Sen. Jim Tracy, state Reps. Kevin Brooks and Joe Carr, former Bradley County Sheriff Tim Gobble, businessman Shane Reeves and state Speaker Pro Tem Judd Matheny.

“You’re probably looking at at least a five-way primary,” a Tennessee Republican strategist said.

And it could well be a fight to the right.

The district, which includes rural and suburban areas, has a strong contingent of members of the Southern Baptist Church and the Church of Christ.

“You go into these little courthouse town squares, and there’s a big Baptist Church and a big Church of Christ downtown,” the Tennessee GOP operative said. “A lot of that district is extremely conservative.”

Though the district was changed in the decennial redistricting process, it was won by a Democrat as recently as 2008. In 2010, DesJarlais unseated then-Rep. Lincoln Davis (D) 57 percent to 39 percent. DesJarlais won a multicandidate primary with 37 percent of the vote.

Roll Call rates the race as Likely Republican.