As outside groups are ramping up their efforts in the intensifying fight over the confirmation of Supreme Court nominee Amy Coney Barrett, 150 liberal groups signed a letter Tuesday asking senators to oppose the nominee.

The letter was organized by The Leadership Conference on Civil & Human Rights, which regularly fiercely opposes President Trump's judicial appointments. But the Leadership Conference's letters are usually signed just by its CEO, Vanita Gupta, and the large number of groups backing the letter is a sign of the organized resistance by left-leaning groups against the nominee -- just as right-leaning groups are redoubling their efforts to support Barrett.

"Judge Barrett’s extreme record on the U.S. Court of Appeals for the Seventh Circuit, along with her ideologically driven writings and speeches, demonstrate that she is incapable of rendering equal justice under law," the letter read. It continued to say that Barrett would be biased on issues from abortion, employment discrimination, gay rights, immigration, gun control and more.

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"In sum, Judge Barrett is an ideological extremist who lacks the fair-mindedness necessary to serve a lifetime appointment at the highest level of the branch of government charged with making the ultimate decisions about our rights, freedoms, liberties, and the meaning of our laws and Constitution," the letter continued. "She should not be confirmed to the highest court in the land."

Meanwhile, conservative groups like the Judicial Crisis Network are organizing their efforts to back Barrett. It expects to spend $10 million throughout her confirmation process and has already done two seven-figure ad buys. One ad from late last month appeared in key states of vulnerable or moderate Republican senators who may be swing votes on Barrett's confirmation, including Colorado, Iowa, Maine, North Carolina and Utah.

"Courts are not arenas for politics. You are not there to decide cases as you may prefer," Barrett says in previous remarks packaged in the ad. "You are there to do your duty and to follow the law wherever it may take you."

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And minutes after the Leadership Conference letter was released Tuesday, the Senate Republican caucus released their own digital ad, which was tweeted by Senate Majority Leader Mitch McConnell, R-Ky.

"President Trump made an outstanding choice in Judge Amy Coney Barrett. She is one of the finest legal minds of her generation," McConnell said. "She’s won national admiration for her example of strong female leadership. She’s exactly the kind of person Americans deserve on their highest Court."

Republicans appear to have the votes to confirm Barrett before the month is out, but they've had to adjust their playbook after three Senate Republicans tested positive for the coronavirus last week. They've moved the Barrett confirmation hearings, set to start Oct. 12, to a hybrid in-person and virtual format over the objections of Democrats.

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When the GOP senators recover from the disease will be key, however, as Senate floor votes are required to be taken in-person. If any Republican senators are still sick by the time McConnell schedules a floor vote on Barrett, it could complicate matters.

Nevertheless, Republicans have expressed confidence they'll have the in-person votes when the time comes, with Sen. Ron Johnson, R-Wis., who tested positive for the virus, swearing on the Denver area talk station KHOW Monday that he would show up in a "moon suit" if he needs to. Democrats, however, have called the Republicans' push ahead with the Barrett confirmation "reckless" both in regard to the virtual hearings -- which the Senate has used regularly for months -- and the coronavirus cases in their caucus.