Ben Nelson kicked out of a pizza joint in Nebraska.

Nebraska Sen. Ben Nelson and his wife were leaving dinner at a new pizza joint near their home in Omaha one night last week when a patron began complaining about Nelson’s decisive vote in favor of the Senate’s health care bill.

Other customers started booing. A woman yelled, “Get him the hell out of here!” And the Nelsons and their dining companions beat a hasty retreat.

“It was definitely a scene in there,” said Tom Lewis, a 41-year-old dentist and registered Republican who witnessed the incident. A second witness confirmed the incident to POLITICO.

It’s a new experience for Nelson.

He used to be a popular figure back home, a Democrat who served eight years in the governor’s office and was elected twice to the Senate by a state that’s as red as the “N” on the University of Nebraska's football helmets.

But Nelson has seen his approval ratings tumble in the wake of his wavering over the historic health care bill, his deal-cutting with other Senate Democrats and, ultimately, his support to break a GOP filibuster and send the bill to a House-Senate conference committee.

Nelson, who has a track record of brokering bipartisan deals, said for months that he was unsure whether to back a Democrats-only bill, and he criticized language in the measure that would impose taxes and cut Medicare costs in order to pay for extending coverage to most Americans. But after weeks of negotiations, Nelson made his peace with the bill by striking deals on his state’s Medicaid costs and on abortion language — and, in the process, incited a furious backlash in Nebraska.

Anti-abortion activists who have supported him in the past have abandoned him; he’s been the target of a fierce campaign by opponents to push him to block the bill on final passage; and the GOP now sees the opportunity for a pickup in 2012.

Meantime, Nelson is still viewed warily by more-liberal Democrats who distrust his conservative leanings and remain upset with his opposition to a public option.

“He’s kind of a man without a state,” said Julie Schmit-Albin, executive director of Nebraska Right to Life, an influential anti-abortion group that had endorsed Nelson’s previous election bids but has “pretty much cut [its] ties” with the senator over the abortion deal in the health care bill. The group plans a rally Jan. 30 in front of the state Capitol in Lincoln and will weigh whether to use its influence to go after Nelson ahead of 2012, when he is up for a third term.

The state Republican Party has set up a website calling for voters to eject Nelson from office, and it has already raised “tens of thousands of dollars” for advertising, according to Mark Fahleson, chairman of the state party.

And Democrats in Washington worry that the pressure may cause Nelson to defect in the end, particularly since the senator — once again — has made clear that his final vote on the bill is not guaranteed.

Nelson, who declined requests for an interview, is responding to the blowback with a major effort to reverse public opinion, criss-crossing the state county by county and holding interviews with a slew of local newspapers and TV and radio stations. He has explained his vote and the deals he made in several newspaper op-eds, held a news conference outside his home in Omaha and made a “sizable number” of calls to individual voters who have written him to express their concerns, according to his spokesman.

Nelson argues that the bill would lower premiums and address the worst insurance company abuses, and he defends the deal he struck on abortion, saying it wouldn’t allow federal dollars to be used on the procedure. He’s also said that he’s working to give all states the benefit of the deal he struck that exempts Nebraska from its new costs under Medicaid after 2017.

The state’s Democratic Party helped bankroll an ad campaign, which began running during the University of Nebraska football team’s appearance in the Holiday Bowl. In the ads Nelson says he was “convinced this is right for Nebraska.” A spokesman for the state party did not return a telephone call.

In addition, Nelson has gone to battle with opposing politicians — pushing back against criticism from California Gov. Arnold Schwarzenegger and 13 Republican attorneys general who have threatened to file a lawsuit arguing that the Medicare deal in the health care bill is unconstitutional.

And he has criticized his own party as well. In an interview with Nebraska’s Freemont Tribune, Nelson said it was a “mistake to take health care on as opposed to continuing to spend the time on the economy” — an unusual move for a senator who usually shies away from openly criticizing his party’s leadership.

Jake Thompson, the senator’s spokesman, downplayed his comments to the Tribune, saying that Nelson was not trying to criticize President Barack Obama or the Senate Democratic leadership but was being more of an “armchair quarterback” when asked about the year’s legislative work.

Asked about the incident at the pizza joint, Thompson said: “If somebody yelled that comment, Sen. Nelson didn’t hear it, and he did hear positive comments from others in the restaurant.”

Thompson also said that “many Nebraskans have thanked Sen. Nelson through phone calls, letters and e-mails for supporting health reform because they know its improvements will help their lives.”

Thompson said Nelson was recently thanked by a man in an Omaha store wearing camouflage clothing, a neighbor who was liquidating investment funds to pay medical bills, a group of diabetic children and a woman in a restaurant.

“On the other side, indeed, there are Nebraskans who do disagree with his vote on health care — some don’t like the bill, some have been misled about what’s in it, some don’t want health reform now, and some disagree for political reasons,” Thompson said. “On balance, Sen. Nelson believes his support for health reform will stand the test of time.”

David Di Martino, a former Nelson aide and now a Washington-based consultant, said that the millions of dollars’ worth of TV ads that doused the state at the end of the year helped shape public opinion — and that, ultimately, anger will subside once people start seeing the benefits of the bill. And he added that, throughout his career, the senator has made a political comeback when pundits ruled him out.

“He’s got a record of coming back and being successful,” Di Martino said.