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It’s safe to say that Republicans are already very worried about the Affordable Care Act.

The leaked Republican replacement plan was met with withering criticism, while Republican governors are recoiling at the real and political damage it might do to them and their states. Reports abound about GOP legislators getting cold feet on the issue. The biggest psychological damage, however, is coming from packed constituent town halls where ACA recipients are asking hard, angry questions about what will happen to their health insurance when Obamacare is dismantled. The town halls are so unnerving Republican legislators that many are coming up with lame excuses for why they refuse to meet their constituents.

But for a politician there is no fear like that of electoral accountability. The first taste of a voter backlash against the party of Trump came in Delaware, where a usually tight state senate district went resoundingly for the Democrat by 18 points and featured remarkably high voter turnout.

But Delaware was small potatoes compared to the test coming up in Georgia’s 6th congressional district. On April 18th, Georgians in the north Atlanta suburbs will be holding a special election to replace Tom Price, who was appointed as Secretary of Health and Human Services. The district has traditionally been safely Republican, but it wasn’t so comfortable with Donald Trump–it only voting for Trump over Clinton by a single percentage point.

That in turn makes it an interesting test case for Democratic prospects in Republican districts where even some Republican voters aren’t very comfortable with Trump. A combination of an engaged Democratic electorate with a disaffected GOP electorate could lead to earth-shattering results. As Chris Bowers, Executive Campaign Director at Daily Kos said on social media:

If, in the upcoming GA-06 special election, we get same same shift from 2016 results that we got last night in the Delaware Senate special election (59-41 Dem from 54-41 Clinton), Democrat Ossoff would win (that seat was 48-47 Trump in 2016).

If that happens, dozens of congressional Republicans in marginal seats will quickly realize that they are extremely endangered if they keep going along with Trump and the GOP leadership. And then things will change.

Indeed. Losing the district would send shivers up the spine of every Republican in a remotely competitive race in 2018. Even winning by a narrow margin would be eye-opening. And as of right now, the leading Democratic candidate Jon Ossoff is the top vote-getter by plurality in the latest poll of the district.

Democrats who want to save the Affordable Care Act would be wise pay close attention to the race and do whatever they can to help. It could make all the difference.

David Atkins

Follow David on Twitter @DavidOAtkins. David Atkins is a writer, activist and research professional living in Santa Barbara. He is a contributor to the Washington Monthly's Political Animal and president of The Pollux Group, a qualitative research firm.