One hour into Sen. Ted Cruzs town hall meeting on veterans issues in McKinney, Texas, on Wednesdaynight, a doctor stood up andtold him, You all are scaring the living daylight out of us with the health care nonsense youre doing.

Cruz, who has been a key playerin the Senates health care negotiations, responded that he is fighting to repeal President Barack Obamas signature health care law, and working to expand choice and competition to lower insurancepremiums.

The process of repealing it in Congress, its been messy. Its been bumpy. I am not certain well get it done, the Texas Republican said, according to a recording of the event. I hope we will. I believe we will.

The exchange highlighted broader questionsfacing Cruz ashe looks to repeal the 2010 law, a stance that helped propel him to national prominence. Does he make the bill more conservative, potentiallycompromising on other aspects of thelegislation? Or does he ultimately vote against thebill becauseit doesnt go far enough? And what will Texas voters think?

Fiveyears ago, Cruz looked into a television camera and said the effort to repeal the health carelawwould be an epic political fight.

There is going to be enormous pressure to compromise, Cruz said. I think we should repeal it in its entirety.

Cruzs comments came during a televised debate with Texas Lt.Gov. David Dewhurst, who also said he wanted to repeal the law.The pair were locked in a runoff for the Republican nomination for the Senate. They weresimilar in substance, but differed in style.

Cruz, a well-spoken lawyer who had never been elected to office, pulled off an upset to win the primary, a major tea party victory.

Fast forward to this summer, and the stridently conservativepolitical outsider is now working on the inside.

Cruzhas been engaged with 12 other colleagues in closed-door discussions on the legislation to repeal parts of the health care law. The senator who oncespoke ofthe pressure to compromise is now welcomed by his colleagues for his willingness to do so.

The quieter, behind-the-scenes style isa changefor Cruz, according to his fellow lawmakers. Four GOP senators used the same word to describe his role: constructive.

It is welcomed, said South Carolina Sen. Lindsey Graham, who was open about the disdain senators felt for Cruz. (Graham once joked that if Cruz was murderedon the Senate floor, a jury of senators would not convict the killer.) Grahamand Cruz both ran for the GOP presidential nominationlast year, losing to Donald Trump.

I think running for president was probably a good experience for him, Graham said. It shows the diversity of the party and being able to solve problems is a good thing.

Senators also positively describe Cruzs willingness to engage in one-on-one meetings. Sen. Rob Portman, who raised concerns about the health care legislations effect on Medicaid recipients, said Cruz cameby his office last week to discuss the stalled bill.

Hes been looking for ways to find compromise, the Ohio Republican said.

For Cruzs allies, his role in the deal-making is no surprise.

Ive known him in private and Ive known him to be a deal-maker the entire time that Ive been in Congress, said North Carolina GOP Rep. Mark Meadows. Many others in the public have not seen that.

Meadows, who chairs the hard-lineconservative House Freedom Caucus, said Cruz and GOP Sens. MikeLee of Utah and Rand Paul of Kentucky have been keeping his caucus up-to-date on Senate developments. But the North Carolina Republicansaid Cruz has been guarded when he talks to House members.

His communications with us have been more strategic and focused thanperhaps just saying, Well, let me share whats going on, Meadows said. Its almost seen as he doesnt want to undermine the credibility he has with some of these senators.

Chip Roy, Cruzs former chief of staff, now at the Texas Public Policy Foundation, said Cruz hasnt shifted his style, but is adjusting to a Republican-controlled government.

Hes trying to reflect and represent the people who sent him to Washington to change it, Roy said. What is different is the operating environment.

Meadows said he didnt expect too many Cruz supporters tobe deterred now that hes working from the inside.

For every person that may wish that he took a more strident position, I think theres at least one, maybe two, that would say were glad that Congress is finally making progress, the congressmansaid.

Cruz also still hasthebacking of conservative outside groups, who support his amendment allowing insurance companies to offer plans without certain coverage areas mandated by the2010 health care law, as long as the companies sell one plan that complies with the mandates.

But his amendment could renderthe current Senate proposal, known as the Better Care Reconciliation Act, too conservative for the more moderate members of the GOP conference. The bill remainsat a standstill, with the risk of nothing getting done to fulfill the promise Republicans have campaigned on for sevenyears.

If nothing gets done, Republicans, and even Cruz, could face a backlash from voters frustratedby inaction.

If theres three votes [against the GOP bill] and hes one of the three that could be a problem, said one Texas GOP operative. I think Obamacares that important to the Republican primary voter.

Others disagreed, since Cruzs opposition would likely be because thebill did not repealenough of the health care law.

The promise is to repeal Obamacare, not to pass anything that has the word health care in it, Texas Republican Party Chairman James Dickey said.

Democrats see Cruzs conundrum as a lose-lose situation for him.

Hes going to have to ultimately vote against this, and have reneged on his years-long pledge to repeal and replace Obamacare, said Matt Angle, a Texas Democratic consultant.Or hes going to vote for and help adopt something that is going to hurt people badly.

Cruz is one of only eight Republican senators up for re-election in 2018, and he already has a Democratic challenger in Rep. Beto ORourke.

The health care debate couldnt come at a better time for Beto ORourke because of the reliance of many of the red counties in Texas on government-sponsored health care, said Colin Strother, a Texas Democratic strategist.

Texas is one of 18 states that did not expand Medicaid under the 2010 health care law. But more than 4 million Texans are enrolled in the program, while roughly 3.6 million rely on Medicare, according to the most recent data provided by Texas Healthand Human Services and the Kaiser Family Foundation.

Localizing the bills impact by explaining how the GOP legislationcould affect Texanswould be a smart move for ORourke, Strother said.

However, Republican voters in the Lone Star State have supported politicians who campaigned on repealing and replacing the 2010 law.Given the statesconservative leaning, GOPoperativesbelieve Cruz is still in a strong position. Inside Elections with Nathan L. Gonzales rates this race Solid Republican.

Cruz also won last years presidential primary in Texas by nearly 17 points. Trump won the state in November by 9 points.

That victory margin for Trump was the smallest for a Republicanpresidential nominee in Texas in twenty years. One GOPconsultant raised concern overhistoric trends, in which the presidents party does not fare well in the first midterm election of the administration, and said its possible GOP voters would stay home.

Democrats say there is arenewed energy around ORourke, the young third-term congressman from El Paso. Republicans say ORourke, who supports a single-payer health care system, is too liberal for Texas. But Democrats think he could have achance.

Smart people are going to be wary that a Democrat can win in Texas right up until they do, said Strother, the Democratic strategist. I think thats kind of a natural state.

To have someone run as a bold progressive that says, Im not ashamed of who I am or what I believe in, thats a different dynamic that we havent seen statewide in Texas, Strother said. And I happen to think its something that we cant handicap for.

As ORourke travels the state taking on Cruz from the left, Republicans are not gearing up for a primary battle. Dickey, the party chairman, said he was not aware of any primary challenges to Cruz, andsaid the party does not take sides in primaries.

GOP Rep. Michael McCaul last year declined to say whether he would challengeCruz. Asked last week if he was considering a primary challenge, McCaul said, I dont want to talk about Ted Cruz.

McCaul criticized Cruz for focusingon his nationalambitions insteadof serving the LoneStar State, a criticism some Texans say the senatorstill faces today. In 2018, Cruz is looking to prove that hes laser-focused on Texas.

I think Sen. Cruz realizes that he took on some negative water from the presidential race and hes trying to move past and showpeople that hes focused on his job, one Texas GOP operativesaid. Its very clear that hes going to be in the Senate for while.

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Cruz Walks Health Care Tightrope, With Eye on 2018 - Roll Call