The Frontier Amendment, part of the health care bill, sends millions in federal Medicare funding to North Dakota hospitals to offset the state's low Medicare reimbursement rate. The North Dakota delegation supports the Frontier Amendment, including Berg. "We need to be extraordinarily careful because I know Congressman Berg has talked on and on and on about repealing and replacing, and what I'm saying is there are provisions in the Affordable Care Act that are unique to North Dakota that will never be passed again," Heitkamp said in a speech Wednesday night. "I will challenge anyone who tells me that you can repeal the Affordable Care Act and get the Frontier Amendment passed as a standalone -- it won't happen." As I noted when Heitkamp launched her June ad, it's not ideal for Heitkamp to have to spend a lot of time talking about the health care law -- in a Republican state where votes view it unfavorably. But it makes sense to try to zero in on a locally popular piece of the law and use it to try to put Berg on the defensive. And the emphasis on one aspect of the law that's popular on the state level also fits with Heitkamp's strategy of keeping a focus on North Dakota issues in a GOP-leaning state where Obama will lose to Mitt Romney in November. If all politics isn't local, to borrow Tip O'Neill's maxim, she's hoping that national politics can be localized to her favor.