Health-Care Activists Targeting Democrats

But in the Senate, where the Democrats do not have the 60 votes needed to stop a filibuster, members are weighing alternatives such as a nonprofit cooperative or a "fallback" provision that would kick in only if market reforms fail.

"Democratic senators are taking millions of dollars from insurance and health-care interests and getting lobbied by those donors and coming out against a position that 76 percent of Americans agree on," said Adam Green, interim chief executive of Change Congress.

While recent polls show high initial support for a government option, the number declines if told the insurance industry could fold as a result. Change Congress and its sister group Progressive Change Campaign Committee are airing cable and Internet ads against lawmakers such as Landrieu and Nelson, who have not endorsed a robust public plan.

Green, in an interview, was hard-pressed to articulate a substantive argument for the public plan but said that it "has become a proxy for the question of Democrats who stand on principle and represent their constituents."

The Web-based MoveOn.org plans to run ads this week against Sen. Kay Hagan (D-N.C.) over the issue.

"The Democrats were voted into office to fix this problem," said MoveOn political advocacy director Ilyse Hogue. "It is absolutely our job to hold them accountable."

One Democratic strategist who is working full-time on health reform was apoplectic over what he called wasted time, energy and resources by the organizations.

The strategist, who asked for anonymity because he was criticizing colleagues, said: "These are friends of ours. I would much rather see a quiet call placed by [Obama chief of staff] Rahm Emanuel saying this isn't helpful. Instead, we try to decimate them?"

Richard Kirsch, campaign manager of the labor-backed Health Care for America Now coalition of 1,000 groups, believes grass-roots pressure and targeted advertising are already having an impact. After the group aired a spot in Pennsylvania attacking Specter for remarks critical of a public plan -- and supplemented that with flyers and phone calls -- the lawmaker shifted.

At an event Thursday, Specter said he is willing to consider a compromise. "That shows Senator Specter has come a long way," Kirsch said.

Listening to constituents, even those speaking over the airwaves, is part of "representative democracy," Specter said.

But Kirsch may still end up being disappointed by the newest Democratic senator. Specter, voicing the sort of flexibility the groups dislike, said, "This legislation is so complicated and so important that we all ought to be flexible and not approach it with fixed positions."

Like Specter, Wyden is sanguine about ads in his home state intended to pressure him to embrace a liberal bill.

"I get an election certificate from the people of Oregon," said Wyden, whose bipartisan health bill picked up its 14th co-sponsor last week. "As far as these ads are concerned, I pay them no attention."