Despite a strong lead, Democrat Jon Ossoff did not attain more than 50 percent in the special election for Georgia's 6th congressional district seat, a former Republican stronghold.
Trump weighed in Tuesday, urging Republicans to get to the polls, and tweeting: "Democrat Jon Ossoff would be a disaster in Congress". Ossoff ended up with 48 percent of the voted, lower than the clear marjority he would have needed for an outright win.
If Ossoff were to finish below the 50 percent threshold - as most Republican and even Democrats expected - he'd then enter a run-off against the second leading vote-getter, in all likelihood a Republican candidate.
While Ossoff and national Democrats acknowledged that they hoped to win the seat outright Tuesday due to the crowded and fractured GOP field, Ossoff will likely enter the runoff with Handel as a slight favorite. And perhaps more significantly, Georgia Democrats have a poor record historically in two-party runoff elections (for example, Democrat Jim Martin lost to Republican Saxby Chambliss by almost 15 points in a 2008 Senate runoff).
"They were ringing my phone off the hook", said Kim Fambro, 45, who said the outreach convinced her to vote for Ossoff.
Georgia's 6th District has belonged to Republicans since 1978.
"Folks in Washington tend to overstate their influence in local races like this", Mr Ossoff told MSNBC.
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The White House said Wednesday that the Democrats "came up short" in Georgia's special election to fill the congressional seat vacated by Health and Human Services Secretary Tom Price, calling it "a big loss for them".
Handel called for Republican unity as she claimed victory.
"Tomorrow, we start the campaign anew, and it is imperative that all of us as Republicans come together", Handel said at her victory party.
However, while they did make impressive strides in traditionally Republican districts, they have yet to prove they can win federal elections in the era of Trump.
A Georgia congressional election is headed to a high-stakes runoff that's shaping up as a referendum on President Donald Trump ahead of crucial midterm elections next year.
"Republicans must get out today and VOTE in Georgia 6". Only about half of reluctant Trump voters approved of the budget.
Handel is the former Komen for the Cure executive who harmed the women's breast cancer non-profit when she tried to defund the group's support of Planned Parenthood.