Just a few years ago, Tom MacArthur was virtually unknown in New Jersey politics. A former mayor of Randolph, a North Jersey town of 26,000, he moved to the Shore to run for an open congressional seat in 2014.

Over the last several weeks, MacArthur burst onto the national scene by brokering a deal with the White House and conservative hard-liners in Congress that revived the GOP's plan to repeal and replace the Affordable Care Act.

The move to help President Trump and Republicans fulfill a key campaign pledge has boosted his stature in Washington and provided a signature moment should MacArthur run for statewide office one day, as some GOP insiders believe he may. As Trump staged a Rose Garden celebration for moving the health bill through the House, Vice President Pence called out MacArthur by name. The two had been in close contact for weeks.

But the health-care gambit carries considerable risk in MacArthur's swing district, including much of Burlington and Ocean Counties, and more broadly in deep-blue New Jersey, where hundreds of thousands have gained health insurance through the Affordable Care Act.

It will surely follow him throughout his political career and more immediately has made MacArthur the poster child for Democrats' plan to use the unpopular GOP health bill against Republicans in key swing districts — including several in the Philadelphia area — in their push to take back the House next year.

Tom gralish / Staff Photographer
Geoff Ginter, a certified medical assistant from Pine Beach, questions Rep. Tom MacArthur at a town meeting in Willingboro.

MacArthur, a former insurance executive and multimillionaire, got a taste of the blowback Wednesday night at a raucous town hall that lasted for about five hours. Hundreds of furious constituents confronted him in heavily Democratic Willingboro.

"I will die if you pass the AHCA!" one person shouted out, referring to the Republicans' bill.

The Democratic National Committee blasted out one video from the town hall to reporters Thursday morning, highlighting an impassioned man who says his wife had cancer and his two children have preexisting medical conditions. "You have been the single greatest threat to my family in the entire world," the man says, his voice rising.

Some criticism has come from within his own party. Last week the two leading Republicans running for New Jersey governor expressed reservations about the House bill. Lt. Gov. Kim Guadagno called it a "disaster."

And in a recent fund-raising solicitation, Andrew Kim, a Democrat considering a run against MacArthur next year, called the incumbent "the main author and lead negotiator for TrumpCare 2.0."

"If he's looking to expand his political horizon beyond his district, particularly in a state that is reasonably supportive of the Affordable Care Act, at this point, it would be a hard sell," said Krista Jenkins, professor of political science and director of Fairleigh Dickinson University's PublicMind poll, though she added that the politics of the issue can be unpredictable.

MacArthur's allies say voters may well reward the congressman for taking action and forging compromise in a gridlocked Washington.

"I didn't go to Congress to be somebody, I didn't go to take up space," he said in an interview Thursday, saying he is aware of the potential political fallout, but not focused on it. "This is a genuine effort to save a crumbling system before a lot of people get hurt."

His plan, dubbed "the MacArthur amendment" in the halls of the Capitol, won him a major legislative victory and put him in close contact with the White House and House Speaker Paul Ryan. MacArthur was in touch with Trump — whose father he knew well from his days decades ago handling Fred Trump's insurance claims — and especially Pence. In the most intense period of negotiation, MacArthur and the vice president spoke practically daily, MacArthur said.

MacArthur has also laid groundwork in New Jersey, forging ties with key Republicans across the state.

"Prior to the health-care conversation, I think it's fair to say the congressman has been slowly building a lot of street credit with the Republican infrastructure," said Dale Florio, former chairman of the Somerset County GOP. "People have been impressed."

If Democrats win the governor's race this year, as they are favored to do, "Tom MacArthur's name will certainly be on many people's short list" to run in 2021, said Bill Spadea, a conservative radio host on New Jersey 101.5. Others see him as a potential Senate candidate next year.

"Man, you don't find many politicians willing to stick their neck out on policy," Spadea said in an interview.

tom gralish / Staff Photographer
Barbara Blonsky of Mount Laurel protests outside a town meeting held by Rep. Tom MacArthur in Willingboro.

MacArthur said he's "not actively" considering statewide office but did not rule it out, saying, "I am always open to where I think I can accomplish the most good."

He said that was his goal in trying to help overhaul the Affordable Care Act, which he blames for rising premiums and diminishing choices. He backed the GOP's original plan to repeal and replace the law, and, when that failed, defied the House centrists to cut a deal with hard-line conservatives and bring the measure closer to passage.

His plan would let states opt out of some Obamacare rules intended to hold down prices for people with costly preexisting medical conditions, like cancer, asthma, or pregnancies. MacArthur said other protections would help such people obtain insurance and keep it affordable for those who maintain their coverage.

Nonpartisan congressional analysts, however, predict that the overall House plan could increase the ranks of the uninsured by 24 million, and independent groups say it will take a toll on states like New Jersey and Pennsylvania, which have expanded Medicaid under the law. Some half a million people in the Garden State have gained health coverage through the provision.

Already, the nonpartisan Cook Political Report, an election forecaster, downgraded MacArthur's chances to win reelection, though his race is still rated "likely Republican."

"The last few cycles, former insurance executive MacArthur's personal wealth has scared top-tier Democrats away from running," wrote David Wasserman, a political analyst for the Cook Political Report. "But his new role as the architect of House Republicans' health-care compromise could make him a target."

The safe thing for MacArthur, said Republican consultant Chris Russell, would have been to stay away from an issue as charged as health care. But Russell, who advised MacArthur on both of his House campaigns, said the congressman wanted to be involved in big issues, "so I was not surprised at all when he decided to put his nose in this thing." If his plan works, it could make insurance more affordable for millions, he said.

But few at MacArthur's town hall believed that.

Elaine Hoffman, a teacher from Hamilton, beamed at the sight of hundreds of people turning out to confront the congressman. She said, "I just hope they turn out in 2018."