Georgia special election stokes raw emotions in final stretch

— -- One of the most expensive and highly publicized congressional races in U.S. history reached its conclusion Tuesday night, after voters in Georgia's 6th Congressional District voted to elect Republican Karen Handel to fill the seat vacated by Secretary of Health and Human Services Tom Price.

Handel saw off a challenge by Democrat Jon Ossoff, after the two had advanced from a crowded field in a vote in April where neither had obtained a majority share.

Though the district has not had a Democratic representative since 1979, supporters of Ossoff, a 30-year-old first-time candidate, hoped to build on the momentum of Hillary Clinton's near miss in the district in November. Observers widely view Tuesday's election as a referendum on President Donald Trump's first five months in office.

In addition to Ossoff's youth and relative inexperience, health care and campaign finance reform became major issues in the district.

Here were some of the storylines in the final day of the campaign.

After Ossoff finished strong in April's special election and fell just short of the 50 percent threshold needed to win the seat outright and avoid a runoff, Democrats saw a real opening and poured in money and resources to help him see the race through.

After their surprising defeat in the presidential contest last November, Democrats have been looking for a win and have been arguing about the best way to appeal to voters. Despite the loss, Democrats are likely to look at Ossoff's race as model for what may or may not work across the county.

Despite his age, Ossoff maintained his composure and stayed on message even under the intensity of the national spotlight.

"For all the attention to the national frame here, what folks want is representation that delivers a higher quality of life," said Ossoff. "This gridlock, dysfunction, scandal in Washington doesn't."

With criticism of the president building among Democrats, he noticeably steered away from about questions about Trump and, unlike his would-be colleagues on Capitol Hill, avoided mentioning the president's name. He acknowledged, though, that the man in the White House has galvanized his volunteers and helped bring in cash.

"It's a big race. The stakes are high. But it is about doing what is right for the people I hope to have the honor of representing," said Ossoff over the weekend.

Constituents in the district said the race was more intense than anything else they have seen in recent memory. Voter fatigue crept in, with phones lines and airwaves flooded with ads from both sides for weeks. One attack ad was so over the top that both candidates said it needed to be taken off the air.

There was an underlying narrative from local Republicans that the left is nearly out of control or militant. Greg Williams, a GOP county chairman and Handel volunteer, told ABC he thought some "alt-left supporters" were doing "damage to the Democratic brand."

Last week a threatening letter containing a suspicious substance — later determined to be baking soda — was mailed to Handel's home. She told reporters Monday the incident only made her more "determined to not be intimidated by anyone."

Asked by ABC News if the tight race in the Republican stronghold made her rethink her hometown, Handel said emphatically, "No."

"The Democrats put a lot of money into this — not for nothing," she said Monday. "A squirrel is going to get a pretty decent percentage of the vote if he has $30 million behind him."

Williams said he was optimistic about the path ahead for Republicans. "I think by the time the midterms come around, the Donald Trump presidency will be well on its way to re-election," he said.

Many of the issues now being debated in the halls of Congress were on the minds of Georgia voters throughout the race.

On health care, NARAL Pro-Choice America launched a six-figure television push attacking Handel, joining Planned Parenthood, which spent more than $500,000 in the race.

In January 2012, Handel was the senior vice president of public policy at Susan G. Komen for the Cure, the largest breast cancer advocacy organization in the U.S., when the organization announced it would cut its funding for Planned Parenthood. At the time, ABC News reported that Komen contributed about $680,000 per year to Planned Parenthood to cover affordable breast cancer screenings.

Komen's decision was thought to be propelled by a 2011 congressional investigation into Planned Parenthood's use of federal funding; critics blamed Handel for Komen's action. Handel resigned a month after the funding decision and denied any involvement with the de-funding, but women's reproductive health advocates see her as an extremist and backed Ossoff with cash and get-out-the-vote efforts. They hoped to send a message to more moderate Republicans that they could help flip a district.

"Karen Handel is a clear extremist," Keauna Gregory, a regional campaign director for Planned Parenthood, told ABC News this weekend. "She has done a lot in her career to defund us. Women know that. People of the 6th [Congressional District] know that."

According to Gregory, Planned Parenthood staffers and volunteers knocked on approximately 80,000 doors in support of Ossoff by the end of the election.

Ossoff kept Planned Parenthood and women's health care at the center of his campaign. His website reads, "Jon will defend women's access to contraception and a woman's right to choose and fight any legislation or executive action that would allow insurance companies to discriminate against women." He ran campaign ads addressing Handel's purported role in the Planned Parenthood de-funding.