WILLINGBORO, N.J. — A year and a half ago, people worried about family members with pre-existing health conditions screamed at Rep. Tom MacArthur at a town hall here. 

The New Jersey Republican didn’t just vote for his party’s health care plan, which had passed the House the week before. He was one of its authors.

A former insurance executive who moved to the 3rd District to run for Congress in 2014, MacArthur was long thought to be untouchable. Before brokering a deal with conservatives on health care, he’d been a leader in the Tuesday Group of moderate GOP lawmakers. He could afford to spend millions of his own money to defend a south Jersey seat covered by two pricey media markets. And he’d won re-election by 20 points in 2016, while this swing district backed President Donald Trump by 6.

MacArthur was an early target of national Democrats, but he seemed to begin the cycle in good shape for a GOP incumbent trying to survive a midterm referendum on the president. 

That’s hardly the case anymore.

Just eight days until Election Day, MacArthur finds himself in one of the most competitive elections in the country. Democrat Andy Kim, a first-time candidate and former national security official in the Obama administration, has outraised the incumbent and is running neck-and-neck with him in most polls. Inside Elections with Nathan L. Gonzales now rates the race Tilts Democratic.

Republicans all over the country — even those who voted against the GOP bill — are on defense over health care this year. But for MacArthur, a legislator with his own deeply personal health care story, it could be his undoing. 

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It’s personal 

The signs have been there since since last May.

When MacArthur then addressed a 300-person town hall here, he talked about his daughter, who died when she was 11. It was a story he’d told in GOP conference meetings ahead of the health care bill’s passage and in media interviews.

It didn’t go over so well. The crowd accused him of exploiting his daughter and pummeled him with stories of their own loved ones scared of losing coverage because of pre-existing conditions. 

Kim has said he entered the race because of health care. When his wife was pregnant with one of their sons, a doctor told them the child might not make it. 

Now, he’s banking on 3rd District voters feeling the same outrage at MacArthur, who was one of two New Jersey Republicans to vote for the GOP health care legislation and the only delegation member to back the tax overhaul.

Over the weekend, Kim rallied supporters at his campaign headquarters here — across the street from where MacArthur’s heated town hall took place last year. 

“When we talk about health care, it’s personal,” Kim told volunteers who’d showed up to canvass during Saturday’s nor’easter. “Remember that moment that is seared in you,” he added, urging them to tell their own stories about why they’re voting Democratic this year when knocking on doors.

Conflicting messages

In the latest Monmouth University survey of the race, which gave Kim a statistically insignificant lead, voters said they trusted the Democrat over the incumbent on health care by a 44 percent to 28 percent margin.

Why does MacArthur think that is?

“I couldn’t tell you that,” he said Saturday after making the rounds at an American Legion centennial celebration in Point Pleasant. 

“We are as committed to covering pre-existing conditions as they are,” MacArthur said. “The whole idea that we’re trying to take away pre-existing conditions has been a lie from the start.”

Nonpartisan experts have concluded that the GOP bill would have weakened protections for people with pre-existing conditions. Although MacArthur’s amendment forbade insurance companies from denying coverage to such individuals, it allowed states to obtain waivers that would have allowed companies to charge them more.

MacArthur’s current rhetoric is consistent with the message coming from many Republicans who are now on defense on health care. He called Kim “part of an angry resistance” and accused the Democratic Party of trying to “whip up anger and division.”

“There’s been an an enormous misinformation campaign that is intentionally trying to make people unhappy so that they vote in a different way,” the congressman said.

To what end?

But if last year’s town hall was any indication, that anger began brewing long before this was a top-targeted race.

Almost all of Kim’s ads since then remind voters that MacArthur was behind the GOP health care legislation. Like many Democratic candidates this year, he’s rejecting corporate PAC money, which has allowed him to amplify his critique of MacArthur — namely that he’s a congressman who answers to special interest donors.

“His particular and personal role in getting the legislation introduced and passed is what sets this race apart and what sets him apart from so many other people running for re-election,” Kim said in a phone interview Saturday as he was driving around the district.

MacArthur acknowledges his position on health care is a factor in this race — but it’s not the only reason he thinks it’s competitive this year, noting that the swingy 3rd District backed former President Barack Obama twice.

And he pointed to other Republicans, like fellow New Jerseyan Leonard Lance, who are also in tough races despite voting against the health care and tax plans on the floor. Lance’s re-election, in a district Hillary Clinton narrowly carried, is rated a Toss-up.

“Leonard Lance voted no on health care, and they’re still going after him on health care. He voted no on taxes, and they’re still going after him on taxes. I don’t think the truth gets in their way,” MacArthur said of Democrats. 

MacArthur stands by his votes for both the health care and the tax bills, saying both are benefitting his south Jersey constituents. 

In the end, the two-term congressman said, he did what he said he was going to do. 

“Look, I ran for office — not once, but twice — telling people that I wanted to lower taxes and I wanted to replace the Affordable Care Act with something that brought costs down,” MacArthur said.  “This is not a mystery.”