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Dem Heitkamp goes on offense on healthcare in North Dakota

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The ad marks a rare instance since the law passed of a red-state Democrat standing up and fighting hard for the law on its merits — many have sought to distance themselves from the legislation or simply not talk about it in 2010, and that pattern has reemerged again this year.

But Heitkamp is on record for her strong support of the law — leading to months of Republican attacks — and she'll need to at least neutralize the issue in order to beat Berg in the heavily Republican state.

A Democratic strategist said the ad is a sign more Democrats will take the issue head-on, and fight with Republicans on the bill.

The National Republican Senatorial Committee counter-punched, pointing to reports that Heitkamp had never questioned portions of the bill until she became a candidate and calling the ad her "revisionist history tour."

"Every victim of breast cancer deserves our respect and admiration, but it's neither admirable nor respectful when you're a politician doing anything and everything to mislead voters on your liberal record," said NRSC Press Secretary Lance Trover. "She couldn't point to even a single instance where she ever said it needed to 'be fixed' until after she decided to run for the U.S. Senate."

The Hill rates this race a "tossup."

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