Republicans' 217-213 passage of the American Health Care Act on Thursday guarantees Democrats will have at least one major on-the-record vote to exploit in the next elections. Although it's the first of potentially many explosive votes, House Republicans' willingness to spend political capital on a proposal that garnered the support of just 17 percent of the public in a March Quinnipiac poll is consistent with past scenarios that have generated a midterm wave. 

Not only did dozens of Republicans in marginal districts just hitch their names to an unpopular piece of legislation, Democrats just received another valuable candidate recruitment tool. In fact, Democrats aren't so much recruiting candidates as they are overwhelmed by a deluge of eager newcomers, including doctors and veterans in traditionally red seats who have no political record for the GOP to attack - almost a mirror image of 2010. 

Of the 23 Republicans sitting in districts won by Hillary Clinton in 2016, 14 voted for the repeal and replace measure. For these Republicans, time is still on their side and healthcare reform can't be disposed of soon enough. There are still 18 months before the 2018 election, whereas House Democrats eked out final passage of the ACA less than eight months before the 2010 midterms. These Republicans can't afford a year-long Senate slog. 

Besides the election calendar, another comfort to these Republicans has been their over-performance in the most recent election. For example, Arizona GOP Rep. Martha McSally took 57 percent in her Tucson district versus President Trump's 44 percent. However, like so many other relatively new Republicans, she has never had to run in a midterm in which voters will view their choice as a referendum on the party in the White House. 

The irony is that Democrats' temptation to refer to the GOP's bill "Trumpcare" may actually raise the popularity of the legislation. Trump's job approval, though low, is still almost double the public support for repealing and replacing some of the ACA's most popular provisions. And Democrats will need to go beyond lecturing voters about the bill's "morally bankruptcy" - their candidates will need to convince independent voters how hard the bill could hit their pocketbooks. 

Still, for several dozen Republicans, adding support for the AHCA to their voting record is an unequivocal political risk. And, several of the 20 Republicans who voted against AHCA could end up being blamed anyway, much as 17 of the 30 Democrats who took a pass on the ACA and then ran for reelection ended up losing in 2010. For others, tough votes could make the prospect of retirement more appealing. 

In light of the vote, we are shifting our ratings in 20 districts, all reflecting enhanced opportunities for Democrats. The major caveat is that 18 months is an eternity in politics and that as always, we will continue to adjust our outlook as events unfold and the landscape develops. View our new ratings here:

AZ-02: Rep. Martha McSally (R) - Southeast: Tucson, Cochise County
Lean Republican. In 2010, Democratic Rep. Gabbie Giffords eked out a narrow win after voting for the ACA in a district that had voted against President Obama. In 2018, McSally will try to replicate that feat in this Tucson seat, which voted for Hillary Clinton 49 percent to 44 percent. For cover, McSally sponsored a last-minute bill to eliminate an exemption for Congress from the AHCA's provisions. But, her vote in favor will certainly spur Democrats' interest here. 

CA-25: Rep. Steve Knight (R) - Northern LA County: Santa Clarita, Palmdale
Toss Up. Knight prevailed with 53 percent in 2016 while Trump lost this rapidly suburbanizing seat 50 percent to 43 percent. Knight's family name is a strength in northern Los Angeles County, but the district's trend line and his vote in favor of the AHCA could make him a top target again. Attorney Bryan Caforio may run again, but non-profit executive Katie Hill and volcano scientist Jess Phoenix are also drawing interest on the Democratic side. 

CA-39: Rep. Ed Royce (R) - Northern Orange County: Fullerton, Yorba Linda
Lean Republican. As the chair of the House Foreign Affairs Committee and one of the longest-serving Republicans in the House, Royce hasn't had a competitive race in years. But his Orange County seat is now just 31 percent white and voted 51 percent to 43 percent against Trump. Democrats believe the ideal profile to take him on could be a political outsider who could make inroads with the district's large Vietnamese community. 

CA-45: Rep. Mimi Walters (R) - Inland Orange County: Irvine, Mission Viejo
Lean Republican. This wealthy southern Orange County district has swung rather violently against Republicans in 2016, as Trump lost the district by five after Mitt Romney had carried it by 12. Walters hasn't been seriously challenged before, but her vote in favor of AHCA has Democrats energized. A pair of UC-Irvine law professors, consumer advocate Katie Porter and former Sen. Chuck Schumer aide Dave Min, are two early entrants. 

CA-48: Rep. Dana Rohrabacher (R) - Coastal Orange County: Huntington Beach
Lean Republican. Not everyone is convinced that Rohrabacher, first elected in 1988, will run for a 16th term. But if he does, Democrats will seek to use his congressional longevity, AHCA vote and unusually sympathetic rhetoric towards Russia and Syria against him, considering the district voted for Hillary Clinton 48 percent to 46 percent. Rohrabacher has just $204,000 in the bank, and Democrats' dream candidate could be a self-funder. 

CO-06: Rep. Mike Coffman (R) - Denver southeast suburbs: Aurora, Littleton
Toss Up. Coffman ended up voting against the AHCA, but his hesitation to announce his position likely won't assuage voters who want to send a message to President Trump next year. In his past three impressive victories, Coffman has been able to contrast his own military service against his opponents' votes in the state legislature. But now Democrats are excited about attorney and former Army Ranger Jason Crow. Coffman hasn't ruled out a bid for governor. 

IL-06: Rep. Peter Roskam (R) - Chicago west suburbs: Wheaton, Palatine
Lean Republican. Roskam was first elected in the Democratic wave year of 2006 over current Sen. Tammy Duckworth, but hasn't had a tough race since. Now, after Hillary Clinton carried this suburban Chicago seat by 7 points, there's a deluge of Democratic interest. Local college trustee Amanda Howland, who took 41 percent last year, is running again, but most early buzz is about Iraq veteran and former Veterans Affairs official Maura Sullivan. 

IL-13: Rep. Rodney Davis (R) - South central: Champaign, Decatur, Springfield
Likely Republican. Downstate Illinois has trended away from Democrats, and Davis appeared to have locked down this seat after taking 60 percent last year. But in a wave environment, this Democratic-drawn seat could still come into play. Democratic state Rep. Carol Ammons of Urbana is in, but she comes from the liberal corner of the district. Democrats' preferred candidate would be state Sen. Andy Manar, who comes from the rural southern end of the seat. 

IL-14: Rep. Randy Hultgren (R) - Chicago north and west exurbs: Batavia, McHenry
Likely Republican. In 2012, Democrats drew this district to pack GOP voters, but these outer Chicago suburbs only voted for President Trump 48 percent to 45 percent. Hultgren's voting record has been reliably conservative. It's still a long-shot for Democrats, but there's some local interest in Navy veteran and high school teacher Victor Swanson, who just announced. This seat would only come into play if there's a big anti-GOP wave. 

IA-03: Rep. David Young (R) - Southwest: Des Moines, Council Bluffs
Lean Republican. Iowa swung hard against Democrats in 2016, but this Des Moines seat is the most urban and best-educated in the state. Young has broken with President Trump on the trade issue, but he stuck by the GOP on healthcare repeal. Office of Consumer Advocate attorney Anna Ryon was the first Democrat to announce, but Pete D'Alessandro, who directed Bernie Sanders' Iowa efforts, just got in and others could join. 

KS-02: OPEN (Jenkins) (R) - East: Topeka, Lawrence
Likely Republican. This Topeka seat was the site of a big upset in the 2006 Democratic wave, and Rep. Lynn Jenkins's retirement has sparked Democratic interest - especially after a close call in KS-04's special election (this seat voted for President Trump by 19 points compared to 27 points in KS-04). 2014 gubernatorial nominee Paul Davis, who carried this seat by 7 points, may well give it a try, while very conservative GOP state Sen. Steve Fitzgerald is running. 

KS-03: Rep. Kevin Yoder (R) - East: Greater Kansas City
Lean Republican. In a bit of a surprise, Hillary Clinton carried this well-heeled suburban Kansas City seat 47 percent to 46 percent. Meanwhile, Democratic investment businessman Jay Sidie held Yoder to a 51 percent to 41 percent win - Yoder's weakest showing to date. Yoder voted for Republicans' healthcare repeal bill and Sidie is in for a second run, but Democrats may have their eye on someone who could spend even more personal money on the race. 

MI-08: Rep. Mike Bishop (R) - Central: Lansing, Detroit exurbs
Likely Republican. This Lansing district leans Republican overall, but gave President Trump his second closest margin of the nine GOP-controlled districts in the state. Bishop took 56 percent last year, but Democrats insist that the sophomore incumbent's support is soft. Democrats are eyeing someone with national security credentials in the mold of former Rep. Mike Rogers, but the seat would only come into play in a big wave. 

MN-02: Rep. Jason Lewis (R) - Twin Cities south suburbs: Eagan, Burnsville
Toss Up. Lewis prevailed by one of the slimmest margins of any GOP freshman in 2016, 47 percent to 45 percent - and followed it up by casting a vote for Republicans' AHCA bill. Former medical device executive and 2016 Democratic nominee Angie Craig is all but certain to run again, and will likely switch up her consulting team. But the biggest difference could be Democrats' high enthusiasm in suburbs like these. 

MN-03: Rep. Erik Paulsen (R) - Twin Cities west suburbs: Bloomington, Plymouth
Lean Republican. In 2016, Paulsen beat state Sen. Terri Bonoff convincingly, 57 percent to 43 percent, while Trump lost these well-educated suburbs 50 percent to 41 percent. But his vote for the AHCA could help Democrats make the argument Paulsen isn't the moderate he says he is. This time, Democrats are looking for a candidate without a voting record to attack, and some hope wealthy vodka and gelato businessman Dean Phillips could fit the bill. 

NJ-03: Rep. Tom MacArthur (R) - South central: Burlington, Toms River
Likely Republican. The last few cycles, former insurance executive MacArthur's personal wealth has scared top-tier Democrats away from running. But his new role as the architect of House Republicans' healthcare compromise could make him a target. Rhodes Scholar Andy Kim, who served as an ISIS expert in the Obama White House, is moving back to Burlington County to run, but Democrats badly need to make inroads into Ocean County to have a chance. 

NJ-07: Rep. Leonard Lance (R) - North central: Flemington, Bridgewater, Summit
Lean Republican. Lance voted against the GOP's repeal bill on the House floor, but Democrats intend to use his vote to advance the legislation in committee against him instead. President Trump lost this highly educated district by a point, and Lance was held to 54 percent against a Democrat who barely ran ads. Banker Linda Weber is running, and there are multiple other potential candidates who could self-fund a race. 

OH-01: Rep. Steve Chabot (R) - Southwest corner: Cincinnati, Warren County
Likely Republican. Chabot hasn't been seriously threatened since GOP-led redistricting added deeply red Warren County to the seat in 2012, but this Cincinnati seat voted for President Trump by about seven points, the narrowest margin of any GOP-held seat in Ohio. It would be a long-shot even in a wave, but Chabot's vote for the AHCA could help Democratic recruitment efforts, considering it's the only remotely competitive district in the region. 

TX-07: Rep. John Culberson (R) - Houston northwest suburbs: Jersey Village
Lean Republican. This seat is Houston's equivalent of Atlanta's GA-06: wealthy, well-educated, and deeply skeptical of Trump. Except Culberson hasn't had a real race in 10 years, only has $132,000 in the bank, and the district actually voted for Hillary Clinton by a point. Two well-heeled Democrats, attorney Alex Triantaphyllis and oncologist Jason Westin, just announced and could be much more credible than 2016 nominee James Cargas (44 percent), who is running again. 

TX-32: Rep. Pete Sessions (R) - North Dallas and suburbs: Richardson
Lean Republican. Sessions, a former two-term NRCC chair, now finds himself one of 23 Republicans sitting in districts Hillary Clinton carried. And it didn't take long for Dallas Democrats to express interest. Even before Sessions cast a vote for the AHCA, attorney and former Baylor football standout Colin Allred and former State Department official Ed Meier (who was lined up to run the Clinton transition team) had jumped in. Expect an expensive race.

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