Bedford, Pennsylvania (CNN)When Mehmet Oz was vying for the GOP Senate nomination in Pennsylvania, his argument was simple: He could do better than any other Republican in the populous and politically moderate counties around Philadelphia in a general election.
The argument -- along with an endorsement from former President Donald Trump -- helped him narrowly win the primary. But as the nominee, Oz faces a new dilemma: Motivating the commonwealth's most conservative voters.
In Pennsylvania's rural, conservative stretches, areas that overwhelmingly voted for Trump in 2020, Oz is somewhat of an afterthought. Many conservative voters in some of these rural counties told CNN they plan to vote for the celebrity doctor. But few were energized by Oz's campaign and the overwhelming reason they plan to back him is their opposition to the Democratic nominee, Lt. Gov. John Fetterman.
It's an issue Oz faced during the primary when he was challenged on the right by commentator Kathy Barnette and others, and keeping the conservative base motivated will be crucial to his general election chances.
"Oz was Trump's candidate, he's not our candidate," said Ned Frear, a voter in Bedford County, which the former President won with about 83% of the vote in 2020.
Frear is a member of a group of retired veterans who meet at the same Route 220 diner to drink coffee and talk politics each week. Oz stopped at the diner back in February -- and narrowly won the country in the May primary. Still, Frear and others are largely unmotivated by the GOP nominee.
"People in Bedford County are probably going to hold their noses and vote for him," Frear said, "because Fetterman is a dead loss as a candidate."
Clay Buckingham, another retired veteran, agreed: "That's my feeling about Oz. I'm sorry that I'm going to have to vote for him, but I'd rather see him as senator than see Fetterman."
"I voted for Kathy Barnette in the primary," added Doug Braendel, another member of the veteran group. "She was my favorite candidate, but so be it. This the candidate, so I've got to go with him."
A vote against Fetterman
For many of these voters, the reason to vote for Oz is Fetterman, a candidate they view as antithetical to their conservative views.
The Democratic nominee has tried to make inroads with rural voters. He has hosted events over the past month in counties such as Indiana and Venango, both of which Trump carried with around 70% of the vote in 2020. And he made an April visit to Bedford, where he pushed the need to raise the minimum wage and stressed not ignoring rural counties.
"Today is about connecting with voters and letting them know that they are not just taken for granted or they're not just like, 'It's a red county, why do we care?'" Fetterman said about a month before he had a stroke that kept him off the campaign trail for two months and has loomed over much of his race against Oz.
Fetterman's campaign believes his path to victory involves keeping Republican margins down in counties like Bedford, while running up his vote totals in urban and suburban areas.
And the Democrat could be aided in that effort by the lack of enthusiasm for Oz from the GOP base. A recent CBS News/YouGov Battleground Tracker survey found Oz supporters were far less enthusiastic about his campaign than Fetterman supporters were about the Democrat's effort.
Just 36% of likely Oz voters said they were "very enthusiastic" about voting for the Republican, while 64% of registered Republicans said they wished someone else had been nominated, according to the poll. In contrast, 63% of likely Fetterman voters said they were "very enthusiastic" about backing him, while 77% of registered Democrats said they were "glad he was nominated."
In counties like Bedford and nearby Somerset, however, the polarization of the country is felt clearer than ever -- it is the antipathy for Fetterman, and the fact he is a Democrat, that is driving out Republicans for Oz.
"Obviously, he's our candidate of choice now, so we need to back him because red is better than blue," said Terri Mitchell, a voter in Somerset County, which Oz lost to former hedge fund executive Dave McCormick in the Republican primary.
Guy Berkebile, the chair of the Somerset County Republican Party, acknowledged the same: "Some of them, it took a little time," he said of Republicans who harbored apprehensions about Oz. "But they're realizing that my best option is to be vote for Dr. Oz."
Berkebile hosted Oz at his company, Guy Chemical, earlier this year. He said that there were plenty of local voters who had doubts about the television doctor at the time.
"We're a very Christian-based, conservative county. They were somewhat hesitant on Dr. Oz at first. They weren't sold on his Second Amendment stance, a lot of pro-lifers here, they weren't sold on if he was pro-life or not," Berkebile said, before adding, "Voting for Fetterman is not an option."
Brittany Yanick, a spokeswoman for the Oz campaign, said the campaign was confident of holding the reddest counties in the state because many of those areas "rely on our energy sector as an economic driver," while also criticizing Fetterman's past stance on fracking.
"Pennsylvania needs a strong leader who will stand up for American values and help heal this country, not make it worse," Yanick said.
During his unsuccessful 2016 run for the Senate, Fetterman expressed support for a moratorium on fracking in Pennsylvania "until we get an extraction tax, and the strictest enviro regulations in this country." He currently does not support a fracking ban and has taken a more nuanced approach about the transition to clean energy.
A boost from Mastriano
Oz could get some help in his bid to consolidate the Republican base from GOP gubernatorial nominee Doug Mastriano, a far-right state senator who upset more establishment candidates in the primary. Mastriano has been a leading voice advancing Trump's false claims of 2020 election fraud, and mainstream Republicans have expressed doubts about his ability to win the general election.
Polls have consistently shown Mastriano trailing Democratic gubernatorial nominee Josh Shapiro, including the recent CBS News/YouGov survey that gave Shapiro a double-digit lead.
But people like Gary Smith, the chair of the Constitutional Republicans of Western Pennsylvania, believe Mastriano's supporters are so loyal to him, they will undoubtedly turn out to vote in November and, while there, will likely hold their noses and vote for Oz.
"Mastriano is so strong that he is going to pull Oz along on his coattails," said Smith, whose group consists of some of the most conservative voters around Jefferson County, which Trump won with 79% of the vote in 2020.
Many in Smith's group supported Barnette in the primary -- and Jefferson was one of the few counties she won in May. But Oz visited the area after his primary win, and Smith said the GOP nominee met with the group and "cleared some concerns up" and "has given us some assurances on pro-life, Second Amendment, things of that nature."
Smith said that even if some in his group still harbor concerns about Oz, "they are going to suck it up and put their big girl and big boy pants on" and vote for him in November.
"Our philosophy is that even if Oz was liberal compared to us, he is an ultra-conservative compared to Fetterman," Smith said. "So, I guess in some ways, politics is relative."