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A National Republican Senatorial Committee ad links U.S. Sen. Bill Nelson and U.S. Sen. Elizabeth Warren on single-payer health care. A National Republican Senatorial Committee ad links U.S. Sen. Bill Nelson and U.S. Sen. Elizabeth Warren on single-payer health care.

A National Republican Senatorial Committee ad links U.S. Sen. Bill Nelson and U.S. Sen. Elizabeth Warren on single-payer health care.

Amy Sherman
By Amy Sherman July 19, 2017

Republicans mislead in ad linking Bill Nelson to Elizabeth Warren on single payer

Republicans are attempting to link U.S. Sen. Bill Nelson to the liberal wing of the Democratic Party that has pushed for single-payer health care.

A Facebook ad by the National Republican Senatorial Committee ties Nelson, D-Fla., to U.S. Sen. Elizabeth Warren, D-Mass.

"Elizabeth Warren doesn't think Obamacare goes far enough," states the Facebook ad, which started July 5. Then it quotes Warren saying "the next step is single payer." The text on the screen continues: "Does Sen. Nelson agree? He has in the past ... Sen. Nelson votes with Warren 90 percent of the time. Tell Sen. Nelson no to government health care!"

Republicans are targeting Nelson because he faces re-election in 2018 in a state won by President Donald Trump and he is likely to face Republican Gov. Rick Scott, a key advocate of repealing the Affordable Care Act.

In June, Warren told the Wall Street Journal that Democrats should run on single payer in 2018.

It’s possible to view the ad and get the impression that Nelson has supported single payer, a system in which government would provide health care coverage for everyone similar to Canada.

A spokeswoman for the NRSC disagreed with that interpretation. She said that the line is a reference to Nelson agreeing with Warren on a majority of votes. The NRSC’s press release announcing the ad raises the question if Nelson will "support Warren’s socialized health care plan."

"It’s a fair question, seeing Warren is advocating for Democrats up in 2018 to run on single payer," Katie Martin, NRSC spokeswoman, told PolitiFact.

We’ll examine the ad’s entire text and issue an overall rating.

Nelson said little about single payer

Nelson has scarcely mentioned "single payer" at all in the years leading up to the passage of the Affordable Care Act, or even since that time.

At an October 2005 speech to the Tiger Bay Club of St. Petersburg, the Tampa Tribune paraphrased Nelson’s answer to a question about health care. The Tribune wrote that Nelson said he opposed a universal, single-payer health care program, but that employers should not be the main source of health insurance for individuals. Large groups of consumers organized into purchasing units should replace employers as group insurance purchasers, he said.

Some Democrats pushed for a single-payer system leading up to the passage of the Affordable Care Act. (There was a time when Barack Obama supported it, too.) But there wasn’t enough support for that route.

In the summer of 2009, Nelson said little about the pending legislation, drawing heat from some Democratic activists. By the fall, he sounded cautiously supportive and called the bill a "starting point."

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Nelson actually pushed back against those who said the health proposal would end up turning into single payer.

For example, during a Senate Committee on Finance markup of the bill on Sept. 29, 2009, Sen. Chuck Grassley, R-Iowa, argued that "the government plan will eventually lead us to a de facto single-payer system of health care."

Nelson disagreed with Grassley’s conclusion. "Now you just made a statement that it will lead to a single payer. How in the world do you make that leap?" Nelson said.

Nelson’s office declined to comment for this fact-check; however, on the day the NRSC ad appeared, Nelson addressed the question of his view on single payer while meeting with college students in Orlando.

"When people say, ‘Are you for single payer,’ I’m having enough trouble right now just keeping the ACA," Nelson said. "America is not ready for single payer, but America is ready — and has — the ACA. People are trying to take that away and take health care away from 22 million people."

Nelson has said he would not vote for the Republican’s Senate health care plan and has called for bipartisan fixes. The legislation has failed to garner sufficient Republican support to proceed.

Comparing voting records

The NRSC sent us a screengrab of CQ data showing a comparison of Warren’s voting record with Nelson’s record between January 2013 and June 27, 2017. The data shows that Nelson and Warren voted the same way on 1,126 votes out of 1,250, or 90 percent.

The fact that members of the same party agree with each other on issues that reach a vote isn’t a surprise in an increasingly partisan atmosphere.

However, the issues that reach a vote don’t tell the full story about a senator’s beliefs, University of Miami political science professor Gregory Koger said.

"The Senate votes on a carefully selected sort of issues, biased toward extremely conservative ideas (to mollify Ted Cruz types), consensus proposals, or middle-of-the-road Democratic proposals," Koger said. "Indeed, one of the reasons the Senate has been dysfunctional is that both parties fight hard to keep many issues from coming to a roll call vote."

Voting together on a carefully screened set of issues does not imply agreement on controversial proposals.

Our ruling

The NRSC said, "Elizabeth Warren doesn't think Obamacare goes far enough: 'The next step is single payer.' Does Sen. Nelson agree? He has in the past ... Sen. Nelson votes with Warren 90 percent of the time."

The ad suggests that Nelson supports Warren on most things, including a single-payer health care system. Actually, Nelson has said he doesn’t support single payer and wants to focus on preserving current law. His voting record is similar to Warren’s, but members of the same party increasingly vote alike due to a lack of bipartisan votes in the Senate.

We rate this claim Mostly False.

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"Elizabeth Warren doesn't think Obamacare goes far enough: ‘The next step is single payer.' Does Sen. Nelson agree? He has in the past ... Sen. Nelson votes with Warren 90 percent of the time."
Wednesday, July 5, 2017

Our Sources

National Republican Senatorial Committee Facebook ad, "Warren’s single payer - Nelson," July 5, 2017

National Republican Senatorial Committee press release, Digital Ad: Bill Nelson & Elizabeth Warren’s $32 Trillion Health Care Plan, July 5, 2017

CQ Transcriptions, Sen. Max Baucus holds a markup on health care reform, (Accessed in Nexis) Sept. 24, 2009

Senate Committee on Finance, Transcript, May 12, 2009

Plos One, "The Rise of Partisanship and Super-Cooperators in the U.S. House of Representatives," April 21, 2015

Sen. Bill Nelson, Facebook, July 13, 2017

Pew Research Center, "Public support for ‘single payer’ health coverage grows, driven by Democrats," June 23, 2017

Tampa Tribune, "Nelson Says He’ll Be Able To Filibuster Gulf Drilling," (Accessed in Nexis) Oct. 15, 2005

Sun Sentinel, "Nelson backs Baucus bill as `starting point,'" Sept. 16, 2009

Orlando Sentinel, "Nelson says GOP health plan loses momentum," July 5, 2017

Tampa Bay Times the Buzz, "Republican ad ties Bill Nelson to Elizabeth Warren," July 5, 2017

Tampa Bay Times The Buzz, "Bill Nelson: time to work on bipartisan fixes to Obamacare," July 18, 2017

AP Planner, "Dem Sen. Bill Nelson urged to support 'a single-payer Medicare for All health care system,'" (Accessed in Nexis)  April 4, 2015

Wall Street Journal, "Elizabeth Warren Tries to Win Back Voters in Trump Country," June 27, 2017

The Hill, "Warren: Dems should campaign on single-payer healthcare plan," June 27, 2017

MSNBC, The Rachel Maddow Show, Transcript Sept. 29, 2017

PolitiFact, "Donald Trump wrongly says Hillary Clinton 'wants to go to a single-payer plan' for health care," Oct. 9, 2016

PolitiFact, "How much would Bernie Sanders’ health care plan cost the middle class?" Jan. 13, 2016

Scott-O-Meter, Fight to repeal Obamacare, Last update March 7, 2017

Interview, Katie Martin, National Republican Senatorial Committee spokeswoman, July 18, 2017

Interview, Ryan Brown, U.S. Sen. Bill Nelson spokesman, July 18, 2017

Interview, Dixon Galvez-Searle, Physicians for a National Health program Communications Specialist, July 18, 2017

Interview, Gregory Koger, University of Miami political science professor, July 18, 2017

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Republicans mislead in ad linking Bill Nelson to Elizabeth Warren on single payer

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