Washington (CNN) - The economy may be the top issue on the minds of Americans, but the first ad of this election cycle by the National Republican Senatorial Committee is all about health care. And the commercial is running on television in Kentucky, a state where the Republicans are trying to hold onto a seat currently held by the party.
The ad which attacks Kentucky Attorney General Jack Conway, the Democrats Senate nominee, came out Tuesday, the same day the Conway campaign released a commercial that suggests that Republican candidate Rand Paul's positions would make selling drugs and even prostitution legal.
"Whose horse is Jack Conway riding? When the U.S. Senate debated a government takeover of health care, Conway supported it," says the narrator in the NRSC ad. "When other states took the Obama health care law to court, Attorney General Jack Conway refused. When Obama and Pelosi cut hundreds of billions from Medicare, Conway still said yes. Big government running health care. Big cuts to Medicare. Jack Conway took their side. Jack Conway. He's not riding Kentucky's horse."
So does the placing of the NRSC's first independent expenditure ad in Kentucky mean that national Republicans are nervous that nominee Rand Paul, the Tea Party backed outsider who defeated establishment GOP candidate Trey Grayson in the primary, may not be able to keep the seat in party hands?
A Republican source with knowledge of the ad says no, and adds that this is a move to "put this state out of reach for the Democrats."
"Our goal is to boost Paul's lead and force the Democrats to make some very tough decisions on why they would spend money in a red state where their candidate trails in the polls," says the source.
A CNN/Time/Opinion Research Corporation survey of registered voters in Kentucky released last Wednesday indicated that the contest between Paul, the son of former GOP presidential hopeful and Texas Rep. Ron Paul, and Conway, was dead even. But other recent polls of likely voters indicate Paul holds an advantage over Conway.
The new Conway campaign ad uses Rand Paul's own words against him.
"I'm for having crimes and having laws against things that are violent crimes but things that are non-violent shouldn't be against the law," says Paul in a clip used in the Conway ad.
The clip of Paul is followed by a number of Kentucky sheriffs saying Paul's position would make selling drugs, promoting prostitution, and even Wall Street and mortgage fraud legal.
"We need a Senator that is going to treat criminals like criminals," adds one sheriff.
The NRSC pushed back against the Conway ad.
"Jack Conway apparently has no other choice but to desperately try to attack Rand Paul instead of articulating his own positions on the issues that matter the most to Kentuckians," says NRSC Press Secretary Amber Marchand, in a statement.
–Follow Paul Steinhauser on Twitter: @psteinhausercnn