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The attack line from Arkansas Democrats is simple: If Rep. Tom Cotton had his way, at least 155,000 of the states poorest residents would lose the health care coverage they just received under a bipartisan plan that other states have imitated.

Mr. Cotton, a Republican trying to unseat Democratic Sen. Mark L. Pryor, has an anti-Obamacare platform that would imperil the bundle of federal dollars that Arkansas is leveraging to buy private health insurance policies for low-income residents, they say.

Democrats in New Hampshire are lobbing similar barbs at Republican Scott Brown as he vies for a U.S. Senate seat. The former senator from Massachusetts is leery of a Concord compromise that also uses Medicaid dollars to buy commercial insurance for more than 50,000 residents.

For some state Republicans, the private option was a palatable way to insure residents making up to 138 percent of the federal poverty level a key, yet optional, pillar of President Obamas health care law.

Now, supporters of Senate Democrats in tough re-election races want to paint Republican challengers into a corner by trumpeting bipartisan state efforts to insure low-income residents without bloating traditional Medicaid rolls.

This is not an issue weve been shy about talking about, Pryor campaign spokesman Erik Dorey said.

Conservatives say Democrats should not confuse tough choices at the state level with success in congressional races. If Democratic incumbents want to dismiss Republican calls to repeal Obamacare, Republican challengers will counterpunch with tales of dropped health plans, higher premiums and narrower doctors networks in the run-up to Novembers mid-term elections, they said.

The federal focus on Obamacare is about the narrow networks, Greg Moore, state director for Americans for Prosperity in New Hampshire, which has run ads against incumbent Sen. Jeanne Shaheen that paint her as the cause of limited health care choices in the Granite State.

Mrs. Shaheen has said she is committed to doing everything I can to assist New Hampshire implement the states Medicaid expansion plan to cover 58,000 people under the states private option plan, which the governor signed last month.

A repeal of the federal health care law would also repeal the States new Medicaid law, which would be extremely costly for New Hampshire and it would move about 50,000 New Hampshire residents to having no health coverage, James Demers, a Democratic strategist in the Granite State, said Monday. That just doesnt make sense for those people and it surely doesnt makes sense for those who would have to pay.

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Democrats, Republicans use Medicaid law as a campaign weapon