South Florida Democrats are betting that healthcare is their winning issue

Miami-Dade County is home to the largest concentration of Obamacare recipients in the country, and Democrats are spending millions on TV ads, certain that healthcare is the number-one issue voters care about this year.

Congress’ attempt to repeal Obamacare during the first two years of Donald Trump’s presidency was one of the highest-profile votes that incumbent Republican Reps. Carlos Curbelo and Mario Diaz-Balart had to take. They both voted to repeal Obamacare in two majority-Latino districts that have nearly 200,000 Obamacare recipients between them.

Now Democrats are convinced that reminding voters of their representatives’ attempts to repeal Obamacare is the way to flip as many as three GOP-held seats in November, along with keeping incumbent U.S. Sen. Bill Nelson in office.

Debbie Mucarsel-Powell is spending nearly $1 million a week on ads related to healthcare in her race against Curbelo.

Donna Shalala has touted her experience running the Department of Health and Human Services under President Bill Clinton and tried to paint her Republican opponent Maria Elvira Salazar as a “cheerleader of Trump” and his policy preferences like repealing Obamacare. Salazar has said she would have voted against the Obamacare repeal bill with Democrats, but expressed support for allowing health insurance to be sold across state lines, an idea that Shalala said was silly.

And Mary Barzee Flores, a Democrat running against Diaz-Balart, focused on healthcare in her first television ad, noting that her father passed away when she was young.

“So when Congressman Diaz-Balart takes over a hundred grand from drug companies, votes to let them raise prices and to take coverage away from people with pre-existing conditions, I know exactly how that’s hurting families,” Barzee Flores said in the ad.

Healthcare is seen as the most important general election issue for Democrats nationwide, and the messaging locally is designed to motivate liberals and peel off older Cuban-American voters who rely on government-subsidized healthcare, traditionally a large bloc of the GOP base, from Republicans.

And healthcare has become a major sticking point in Bill Nelson’s bid to keep his Senate seat. An outside super PAC aligned with Nelson dropped millions into an ad that hits opponent Rick Scott for declining to expand Medicaid while governor.

“The Affordable Care Act with Medicaid would have 2.5 million people in this state that would have healthcare that never did. He would try to kill the law and that’s a huge difference between us,” Nelson said at a recent debate with Scott.

Republicans have tried to fight back, with various ads being run that they want to protect access to healthcare for people with preexisting conditions, one of the components of Obamacare. They also argue that Democrats want to expand government run healthcare into a “Medicare for all” system espoused by liberals like Bernie Sanders.

Shalala, Mucarsel-Powell and Barzee Flores are all supportive of Medicare for all, but say that protecting and fixing existing law is their top priority if elected, and Shalala fended off a host of primary challengers who ran on a more liberal healthcare message. Nelson has frequently said that he’s focused on trying to save Obamacare and hasn’t thought about Medicare for all.

In the governor’s race, Democrat Andrew Gillum has pledged to expand Medicaid if elected, though the idea faces long odds in a GOP-controlled Legislature, while Republican Ron DeSantis hasn’t released a healthcare plan yet.

A poll released earlier this month by a group that wants to keep Obamacare and expand Medicaid in Florida found that 60 percent of Floridians think healthcare is the most important issue or a very important issue in this year’s election.

“One out of every eight families in our district depend on the Marketplace for their health care, and more than 300,000 people here have a preexisting condition like diabetes, asthma or cancer,” Mucarsel-Powell said in a statement. “Unlike Congressman Curbelo, I would never vote to strip away their access to quality care, or to end the protections they have against insurance companies that would deny them coverage for their pre-existing conditions.”

Portions of Obamacare were repealed by Congress over the past two years as part of the GOP’s tax bill, but the law remained in place when the late Sen. John McCain voted against his party and killed the bill that Curbelo and Diaz-Balart voted for in the House of Representatives.

Republicans are attempting to use the tax bill and a low unemployment rate as a pitch to potential voters, and a recent independent poll of Shalala’s district showed that healthcare ranked as the third most important issue for potential voters —behind the economy and immigration — though non-Hispanic voters rate healthcare as more important than immigration.

Shalala has touted her Cabinet experience on healthcare, arguing that she’ll be ready to help draft policy and command more attention than the average first-year member if Democrats win a majority in November.

“I’ve been working in healthcare a long time and I’ve been teaching the politics and economics of healthcare for 30 years,” Shalala said during her primary campaign. “So I’m considered an expert on the policy issues.”

Alex Daugherty, @alextdaugherty, 202-383-6049