By Ashley Parker

New York Times News Service

WASHINGTON — The ad supporting Rep. Ann Kirkpatrick, D-Ariz., opens with a montage of Americana Main Streets, followed by the green fields and dirt roads of the West — the “small towns and wide-open spaces,” the narrator explains, where Kirkpatrick “listens and learns.”

His voice remains tranquil even as he turns to a more cutting message about President Barack Obama’s signature health care law: “It’s why she blew the whistle on the disastrous health care website, calling it ‘stunning ineptitude’ and worked to fix it,” he says, before adding, “Ann Kirkpatrick: Seeing what’s wrong, doing what’s right.”

As Democrats approach the 2014 midterm elections, they are grappling with an awkward reality: Their president’s health care law — passed almost entirely by Democrats — remains a political liability in many states, threatening their ability to hold on to seats in the Senate and the House.

As a result, party leaders have decided on an aggressive new strategy to address the widespread unease with the health care law, urging Democratic candidates to talk openly about the law’s problems while also offering their own prescriptions to fix them.

The shift represents an abrupt change from 2010 when House Democrats tried to ignore the law entirely and “got their clocks cleaned,” said Sen. Christopher Murphy, D-Conn., referring to the more than 60 seats that Republicans picked up to regain control of the House.

“Part of what we learned in 2010 is that this is a real issue of concern to voters and you can’t dodge it, you have to take it on, and I think Democrats are much more ready and willing to do that in 2014,” said Geoff Garin, a Democratic pollster who has done surveys for Democrats on the law. “We certainly have enough evidence now that this is not a fight you can win if you are in a defensive crouch.”

Democrats will need plenty of offense as they face a multimillion-dollar advertising assault from Republican-aligned interest groups and candidates that want to make the midterm elections a referendum on the Affordable Care Act, using the law as an exemplar of the government’s ineptitude in managing a vast national program.

Democrats say their new approach is consistent with polling data that shows Americans would prefer to try to improve the law rather than repeal it.

In a CBS News poll conducted in January, 56 percent of respondents said that the health law contained some good things, but that changes were needed to make it work better, while 34 percent said the law needed to be repealed entirely.

A new ad by Alex Sink, a Democrat running to fill the open Florida seat previously held by Rep. Bill Young, a Republican, embodies the “fix, but do not repeal” message: After a narrator warns that her opponent “would go back to letting insurance companies deny coverage,” Sink addresses the camera and says, “Instead of repealing the health care law, we need to keep what’s right and fix what’s wrong.”

Similarly, in a Senate Majority PAC advertisement supporting Rep. Bruce Braley, D-Iowa, who is running for the open Senate seat there, the narrator praises Braley for his willingness “to fix the health care law, make it work for Iowa, and hold insurance companies accountable.”