Republican strategists in the state acknowledge that the top issues for voters in key districts in next week’s elections are expanding health care coverage and enacting gun control, political terrain that favors Democrats…

In the Richmond suburbs, Glen Sturtevant, a Republican state senator, called himself “independent minded” in a Twitter thread boasting of times he’d broken with party leadership. In television ads, he says he’s fighting health insurance companies over denying coverage for pre-existing medical conditions and “surprise billing.” He had opposed Medicaid expansion for years before voting for it in 2018, and backed legislation that would have allowed insurers to offer “catastrophic” plans that do not cover pre-existing conditions.

Siobhan Dunnavant, a Republican delegate running for an open Senate seat near Richmond, says in an ad that she “supported a federal ban on bump stocks used in mass shootings.” She voted to block a bump stock ban in the House of Delegates.

And ads for Randy Minchew, a former Republican delegate aiming to retake his old seat in Loudoun County, northwest of Washington, say he favors “stronger laws to keep guns out of the hands of those who would do us harm.” Mr. Minchew carried an “A” rating from the National Rifle Association in each of his last two campaigns.