It’s only the second week of the 116th Congress, but Democrats are already trying to put Republicans on record on protecting people with pre-existing health conditions.

Democrats made health care a major issue in the 2018 midterms on their way to picking up a net of 40 seats and taking control of the House. A vote Wednesday to defend the 2010 health care law — designed in part to illustrate Republicans’ opposition to it — is a sign Democrats see the issue as one that can help them hold their majority in 2020.

“In November, the American people delivered a new Democratic House Majority with a stern message for Washington: Republicans’ attacks on health care must end,” Speaker Nancy Pelosi said in a statement last week announcing a standalone vote to defend the 2010 law, which will complete consideration of the broader House rules package.

Also watch: Pelosi, Lewis and House Democrats unveil legislative agenda for 116th

House Majority Leader Steny H. Hoyer told reporters Tuesday that Republicans who claim they’re for protecting pre-existing conditions have an opportunity to prove it Wednesday as the House votes on Title III of Democrats’ rules package for the new Congress. (The House passed Titles I and II last week.)

Title III authorizes the general counsel on behalf of the speaker and the House to intervene in the Texas v. United States case, which is in the appeals process after a federal judge struck down the 2010 law as unconstitutional.

The measure also authorizes the general counsel “to protect the institutional interests of the House” by defending the constitutionality of the law, “including the provisions ensuring affordable health coverage for those with pre-existing conditions,” in any other suits that may arise.

While the vote is not a requirement for the House to intervene in the Texas case — House General Counsel Douglas Letter has already filed a motion expressing the chamber’s interest in upholding the law — it’s meant to affirm members’ support for doing so.

Democrats are painting the vote as a test of whether lawmakers actually support the law’s protections for pre-existing conditions. To that end, the rule includes language on House findings that up to 133 million non-elderly Americans have some type of pre-existing health condition and that without the 2010 law’s guaranteed issue and community rating protections “millions of Americans could once again lose access to affordable, comprehensive health insurance.”

Throughout the 2018 campaign, Republicans maintained that they supported protections for pre-existing conditions. Hoyer said Wednesday’s vote will allow them to “defend what they say they are for.”

Pushing back

Republicans were quick to accuse Democrats of playing politics.

“Once again Democrat extremists are engaging in political stunts instead of working to fix our broken health care system or end their radical shut down,” National Republican Congressional Committee spokesman Bob Salera said.

But some moderate Republicans who could be Democratic targets in 2020 could face pressure to support the measure.

Roll Call emailed the offices of the 26 House Republicans who could feel the most pressure to support the measure — those who won their races in November by 5 points or less — to see how they planned to vote. Only two provided answers.

Texas Rep. Chip Roy, who won his 21st District seat by nearly 3 points, said he plans to vote “no.”

“Speaker Pelosi should focus on doing her job under Article I, to restore health care freedom to all Americans to drive down costs and increase choices, rather than running to the courts to prop up a failing, unconstitutional healthcare law,” he said in an emailed statement.

Another Texas Republican, Rep. Pete Olson, who won re-election by 5 points, also said he would vote against the measure.

“The new Democrat leadership is attempting to intervene and exploit the serious issue of pre-existing conditions for political gain,” Olson spokeswoman Cate Cullen said in a statement.

Roll Call caught up Tuesday evening in the Capitol with a few Republicans whose offices didn’t respond. New York Rep. Chris Collins said he’d vote against the measure, while Michigan Rep. Fred Upton said he hadn’t looked at it yet to make a decision. Texas Rep. Will Hurd and New York Rep. John Katko also hadn’t yet decided how they planned to vote, but they rejected the Democratic effort to use the vote to define Republicans’ stance on pre-existing conditions.

“Pre-existing conditions are a bipartisan issue. Republicans and Democrats support it,” Hurd said. “Of course, they’re going to portray it like that, but even they believe Obamacare is not working since they’re pushing Medicare for All.”

GOP leaders aren’t expecting many of their members to take the Democrats’ bait and vote for the measure.

“House Republicans have a record of protecting Americans with pre-existing conditions,” a spokeswoman for Minority Leader Kevin McCarthy said. “Just last week on the House floor we filed a motion that required committees report legislation to protect those with pre-existing conditions, which Democrats refused to support.”

NRCC Chairman Tom Emmer said he always tells members to vote in a way they believe will take care of their constituents. But he is not worried about Democrats trying to use Wednesday’s vote to define Republicans as against pre-existing conditions.

“They try to get gotcha moments all the time, and I think Americans generally are a lot smarter than people give them credit for. They’ll see that,” the Minnesota Republican said.

Signs of support

In a vote to reopen the government last week, some Republicans showed an early willingness to buck their leadership.

Seven Republicans voted for a package of six appropriations bills to fully fund shuttered departments and agencies, other than the Department of Homeland Security, through Sept. 30, the end of the fiscal year: Hurd, Katko, Upton and Reps. Brian Fitzpatrick of Pennsylvania, Peter T. King and Elise Stefanik of New York and Greg Walden of Oregon.

Fitzpatrick, Hurd and Katko — the only Republicans to survive last year in districts that Hillary Clinton won in 2016 — as well as Stefanik and Rep. Christopher H. Smith, the last remaining Republican from New Jersey, voted for a separate measure to reopen DHS through Feb. 8.

This week, Democrats plan to drive home the point and continue to put pressure on Republican with separate votes on the Financial Services, Interior-Environment, Transportation-Housing and Urban Development, and Agriculture appropriations bills.

More Republicans are expected to join Democrats in voting to reopen portions of the government as limited public support for the shutdown continues to fade.

In an effort to stem that tide, Vice President Mike Pence and Homeland Security Secretary Kirstjen Nielsen met with House Republicans on Tuesday evening to convince them to stand with the administration as it tries to get Democrats to acquiesce to its demand for $5.7 billion in border wall funding.

Bridget Bowman and Simone Pathé contributed to this report.