WASHINGTON (AP) -- Democratic Rep. Ami Bera has been making a habit lately of bucking his own president and voting with the Republican majority in the House as it moves to amend or overturn parts of the national health care law.
Bera, a physician who favors expanding access to health coverage, said that's consistent with his position that Congress should keep what works in the law and fix what doesn't. Yet it's also a political strategy for a freshman lawmaker running for re-election in a swing district, even in left-leaning California.
He is one of a handful of Democrats who represent districts that are closely divided between the two major political parties. A voter-approved independent redistricting process in California has led to several highly competitive seats and forced politicians to appeal to middle-of-the-road voters.
Bera said his focus in voting with the GOP has been on controlling the cost of health care for patients and employers. He said he hopes voters will prefer someone with his experience as a medical doctor for two decades making changes to the law. A complete repeal, however, is not an option, he said.
"We shouldn't go back to a time when, if you come down with cancer, your health insurance can drop you," he said.
Other California Democrats who have at times sided with House Republicans on various health reform votes include Reps. Julia Brownley, Jim Costa, Scott Peters and Raul Ruiz.
Republicans said voters concerned about the impact of the health law will see the Democrats' occasional siding with the GOP as simply a political ploy.
"People think there's nuances, that these members can throw a vote or two the other way and say 'I'm for correcting it,'" said House majority whip Kevin McCarthy, a Republican from Bakersfield. "No, it's much bigger, and people have made a decision."
McCarthy said opponents of the health care law are much more motivated to vote this year than those who support it, which should be an advantage for Republicans.
Republicans have held more than 50 votes on changing or repealing the law over the past three years, knowing most would die in the Democratic Senate. The intent of the votes was to give their candidates ammunition against incumbent Democrats in competitive districts.
The fix-it approach by the Democrats could be low-risk. The GOP bills would pass the House with or without their support. They and Democratic Party leaders know their votes will not change the law yet can moderate their records and help them appeal to a wider swath of voters.
Peters, of San Diego, joined Bera last month when 12 Democrats voted to delay the penalty for failing to purchase health insurance coverage.
Last week, Bera, Peters and Costa, who represents a Fresno-area district, joined 15 other Democrats in voting for a bill that sought to change the law's definition of full-time work from 30 hours a week to 40 -- raising the threshold at which employers would have to provide insurance.
On another high-profile vote, Bera and Peters were joined by fellow freshmen Brownley and Ruiz in voting for a bill that would delay the requirement that larger employers offer their full-time workers the chance to enroll in a health plan.
Those four are Republicans' chief California targets in this year's elections.
Rep. Steve Israel of New York, who oversees the Democrats' House elections effort, said he believes they have voted as most of their constituents had wanted.
"All of these polls agree on at least one thing: Voters in California want the Affordable Care Act fixed and improved, not repealed," Israel said. "Every time a California Republican insists on repealing the bill, they may animate their base, but they are losing independents and moderates."
This year's elections will be the third straight in which GOP opposition to the law will be a central focus. That strategy allowed the GOP to take the majority in the House during the last midterm elections in 2010.
Yet it's a strategy that has not worked so far in California, which has the nation's largest congressional delegation and where Democrats hold 38 of 53 seats.
With the Affordable Care Act taking full effect this year, Republicans seem anxious to test it with Bera. All three GOP challengers have called for repealing the law. The top two vote-getters in the June 3 primary -- regardless of party affiliation -- move on to the general election.
Peters' race is the only one so far to attract significant outside money. Americans for Prosperity, a conservative group backed by billionaire brothers Charles and David Koch, aired TV commercials criticizing the health reform bill. Three Republicans are vying for the seat.
The GOP has recruited members of the California Legislature to challenge Brownley and Ruiz. Brownley said she wishes Republicans had sought to work with Democrats to improve the health care law rather than dismantle it.
"This is not a political play on my part. This is about trying to, when the opportunities come up, work toward improvement," she said. "I believe strongly that's where the majority of my constituents are."
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