“Joe Donnelly, Heidi Heitkamp, Joe Manchin, we know you stood with us in fighting back the repeal of health care. We need you to stand with us now,” said Brian Fallon, the executive director of Demand Justice.

The three senators’ excruciating dilemma underscores how Kennedy’s decision to retire has scrambled the midterm landscape in favor of Senate Republicans. The GOP has charted a path to keeping its narrow Senate majority through Trump-friendly states represented by Democrats.

Facing pressure from the right, the Judicial Crisis Network, a conservative group, announced a seven-figure ad campaign urging the centrist Democrats to support Trump’s nominee. The ads told voters to call their senators and ask them to help Trump install another justice. They are airing in North Dakota, West Virginia and Indiana, among other states.