There are many members of the House Democratic majority — including those who may face tough re-election contests in 2010 — concerned about what the final health overhaul bill is going to look like. But the debate has special resonance for two-term Rep. Steve Kagen of Wisconsin’s 8th District, which only recently had a reputation as a stalwart Republican stronghold.

The health care issue hits close to home for Kagen because he is a physician.

It is also central to his efforts as a lawmaker, because accessibility to health care has been his trademark issue in his two House campaigns, both of which produced victories over Republican John Gard, a former state Assembly Speaker.

“It’s his basket that he’s going to put his eggs in,” said Timothy Dale, a political science professor at the University of Wisconsin. The public’s perception of Kagen’s efforts to influence the health legislation “will go a long way to predict how well he will run next year.”

“It’s a very personal subject for me, having practiced medicine for 30 years and cared for thousands of people and who couldn’t afford [it]. It’s the reason why I came to Congress,” Kagen said in an interview.

Kagen defeated Gard by a narrow 2 percentage-point margin in the 2006 race to succeed Mark Green, the four-term Republican who that year was the unsuccessful challenger to Democratic Gov. James E. Doyle . Although Republicans tried to portray that as a fluke outcome of the year’s national Democratic surge to a House majority, Kagen improved his margin to 8 points in his 2008 rematch with Gard.

That does not, however, necessarily mean Kagen is secure in the 8th District, which includes Green Bay, Appleton and sizable amounts of rural territory in northeastern Wisconsin. While Barack Obama in 2008 scored an unusual presidential-vote success for the Democrats in the 8th when he outran Republican John McCain by the same 8-point spread, the district’s voters just four years earlier favored Republican George W. Bush for re-election by 11 points.

The economic recession could strengthen Kagen’s stance that the government needs to take assertive actions to deal with problems in the health care system, according to Wendy Scattergood, a political science professor at St. Norbert College in the 8th District city of DePere. Scattergood said the district, which has an economically important manufacturing base, has been heavily affected by the downturn, which in turn has made residents more apt to look for solutions from the government, including on health care.

Thus, enactment of health care legislation that can draw solid public support could enable Kagen to maintain the backing of independent voters, who Scattergood said comprise upwards of 20 percent of the 8th District electorate.

Republican officials argue, though, that the health care debate carries a possible political downside for Kagen. “People are concerned with a government takeover, and they are afraid that consumer choice would be taken away,” said Mark Jefferson, executive director of the Wisconsin Republican State Committee.

Kagen will have a new Republican opponent for the 2010 race, as Gard is not seeking a third try. Three Republicans have stated their intentions to pursue their party’s nomination: Door County Commissioner Marc Savard, Brown County Supervisor Andy Williams and businessman Reid Ribble.

But each appears to enter the campaign as an underdog to Kagen. Kenneth Mayer, also a political science professor at the University of Wisconsin, described all three as having little previous political experience and said they are “running from weak foundations.”

And any of the Republican contenders will have a hard time competing with Kagen’s proven fundraising clout; he owns a string of allergy clinics in Wisconsin and poured considerable amounts of his personal wealth into his previous campaigns.