It’s been less than a week since President Obama gave his stamp of approval to the most sweeping health care overhaul since Medicare, but the new law is already stirring political passions in North Carolina and affecting races for state and federal office.

On Wednesday, the five Republicans in North Carolina’s congressional delegation signed a letter encouraging Attorney General Roy Cooper to join a multi-state lawsuit challenging the constitutionality of the new health care regulations, arguing that Congress can’t force citizens to buy coverage. Attorneys general in 13 states have joined the suit so far, but Cooper hasn’t confirmed he’ll add his name to the list.

Meanwhile, N.C. Senate Minority Leader Phil Berger, an Edenton Republican, is planning to introduce legislation in the General Assembly’s short session to exempt state residents from the new health care mandates. He has asked Gov. Bev Perdue to support the bill.

Similar legislation already has been filed in 34 states, and lawmakers in another five states have announced their intentions to introduce bills this year, according to the American Legislative Exchange Council.

The health care fight also will play a role in the 50 seats in the state Senate and 120 in the state House up for grabs in November. Democrats say it’s too early to tell how the debate will pan out in the midterms, but it could have an impact.

“It may be that it becomes a huge issue in a congressional race, and someone gets washed away in the tide,” said Rep. Deborah Ross, a Wake County Democrat and House Majority Whip. “It depends on the district, what we’re talking about in November versus today, and what the member has or hasn’t done.”

On the other hand, Republicans aim to use the federal lawsuit and state-level legislation to force their opponents to stake out a stance.

“When you look at the bill in totality and see all the provisions that are potentially unconstitutional, those are the ones we’ll focus on and try to carve out where state legislators will need to take a position,” said Republican House Whip Thom Tillis of Mecklenburg County.

Opponents have leveled much of their criticism at the individual mandate, which requires each resident to purchase health insurance or face a tax penalty.

National and state polls show that voters haven’t warmed to the proposal. A Rasmussen Reports survey taken the weekend the bill passed found 41 percent of likely voters in favor and 54 percent opposed. A Civitas Institute poll last week showed a majority of North Carolina voters favored scrapping the bill and starting over.

The prospect of a constitutional convention could also play a role in the political crossfire. To call a convention, 34 state legislatures would have to pass a resolution and 38 would then need to approve an amendment overturning the health care law.

Republican South Carolina Lt. Gov. Andre Bauer has already called for a legislative resolution in the Palmetto State.

Berger said he hasn’t discussed the possibility of a similar resolution in North Carolina. “The lawsuit, the legislation, and the election will help reconcile the situation,” he said. “It can’t be undone in a short period of time. There are some things in the bill the Republicans could support, but overall it’s horrendous.”

David N. Bass is an associate editor of Carolina Journal.