Dean Heller-Jacky Rosen Nevada Senate race becomes referendum on Obamacare

For six years, Republicans won election after election by focusing on Obamacare, and now Democrats are hoping to return the favor.

Democrats have teased out the 2010 Affordable Care Act’s most popular piece — the requirement that people with pre-existing conditions cannot be denied insurance — and used it to bludgeon House and Senate Republicans who have supported repealing or replacing the sweeping government health care program.

Nowhere is the strategy more evident than in Nevada’s senatorial race, where Democrats have sought to defeat Republican Sen. Dean Heller by turning the crucial election into a referendum on health care coverage.

At least a dozen ads attacking Mr. Heller on pre-existing conditions have aired during the hard-fought campaign, most recently a Monday spot from Rep. Jacky Rosen, the freshman Democrat challenging the incumbent viewed as the current election cycle’s most vulnerable Senate Republican.

“One in four Nevadans has a pre-existing condition … and Dean Heller is lying about helping us,” says an ad that ends with a man declaring, “Senator Spineless.”

The Heller campaign denounced the “ridiculous” ad, saying it “shamelessly lies about Dean Heller’s record,” but the onslaught of such ads has kept the health care issue out front despite the Republican’s best efforts to swing the conversation to the booming economy and his support for veterans.

The tactic represents the flip side of the 2010-2016 offensive in which Republican candidates racked up victories by denouncing Obamacare’s rising premiums, its individual mandate to purchase insurance and the dwindling choice of health care plans.

The Senate Majority Project, Democratic Senatorial Campaign Committee, and Majority Forward have also run spots blasting Mr. Heller on Obamacare, although most Democratic advertising doesn’t mention the “O” word or even the more formal “ACA” — from the Affordable Care Act.

“I think the Democrats see the health care issue as a particular weakness for Heller,” said Ian Bartrum, University of Nevada, Las Vegas law school professor.

He noted that popular Republican Gov. Brian Sandoval, who has appeared in an ad endorsing Mr. Heller, “was among the first to announce that Nevada would opt in to the expanded Medicaid plan, and health insurance is a significant issue for the many service-industry workers in Las Vegas.”

“So it’s good traditional ground for the Democratic base, and probably for some percentage of independent voters,” Mr. Bartrum said.

That said, the relentless focus on Obamacare has yet to budge the polls. The race has essentially been a statistical tie since the June primaries, even though both campaigns have raised well over $10 million and the advertising has gone almost entirely negative.

An NBC News/Marist College poll released Tuesday found Mr. Heller with a slight edge with 46 percent, ahead of Ms. Rosen at 44 percent, but still within the 5.5 percent margin of error.

The Heller campaign has blasted the health care attacks, arguing that the senator voted in favor of the unsuccessful “skinny repeal” in July 2017 that would have protected patients with pre-existing conditions.

That vote came after he voted to open up Senate debate on a House bill to repeal and replace Obamacare, which he opposed, prompting Democrats to accuse him of caving to pressure from President Trump.

Republicans have accused Ms. Rosen of being all talk and no action, slamming her for failing to put forward any specific solutions despite her barrage of health-care ads and ambiguous calls to “fix Obamacare.”

In one of the few campaign ads that do use the O-word, Ms. Rosen acknowledges that “Obamacare has real problems, but we should be working together to fix it and bring down costs. Repealing it is just partisan politics, and that hurts Nevada.”

Heller spokesman Keith Schipper responded that Ms. Rosen “has done nothing on health care. Zero.”

“She didn’t introduce a bill to fix this broken system before deciding she wanted a job promotion,” Mr. Schipper said. “Nothing to address skyrocketing premiums. Zero to improve health care access. Congresswoman Rosen throws out vague phrases on television, and it should concern Nevadans that she doesn’t even have a plan to fix this broken health care system.”

Democratic missives on pre-existing conditions have also cropped up in tight Senate races in Arizona, Montana and North Dakota.

Sen. Heidi Heitkamp, North Dakota Democrat, has accused Republican Rep. Kevin Cramer of voting to deny coverage to patients with previous diagnoses based on his vote to repeal Obamacare, prompting a response from the Cramer camp.

“Kevin Cramer voted for guaranteed coverage for pre-existing conditions,” says a Cramer video featuring a herd of cattle. “And Heidi’s ads attacking Kevin on health care? They don’t pass the smell test.”

For Democrats, another bonus of the health care ads is that they highlight an awkward moment between Mr. Heller and the president. Many feature footage of Mr. Trump gesturing to Mr. Heller in 2017 and saying, “He wants to remain a senator, doesn’t he?”

Mr. Trump moved to smooth over the friction between the two at his Sept. 20 campaign rally in Las Vegas, saying he and Mr. Heller “weren’t friends” initially but “then we started to love each other.”

“The fact is he has been a tremendous supporter ever since I won the election,” Mr. Trump told the crowd. “He’s always been there. We can always count on his vote. I mean, wacky Jacky will never vote for us, folks.”