Democrats made the 2018 midterm elections a referendum on affordable health care, specifically coverage protections for people with preexisting illnesses. They banged that drum so hard that most Republicans, even those most ardently opposed to the Affordable Care Act, were forced to clarify that they didn’t want to take away those protections.

Now, Senate Democrats are using President Trump’s nominee to the U.S. Court of Appeals for the 6th Circuit as a cudgel to make the case that Republicans don’t care about protecting sick Americans’ health care.

Is that a leap? Well, not really. Chad Readler, during his time as acting assistant attorney general for the Civil Division at the Justice Department, filed a brief in support of a lawsuit brought by 20 red-state governors and attorneys general against the ACA. A Texas judge in mid-December sided with those states and ruled the law unconstitutional. If the ruling is upheld, it would kill the entire law, including the popular provision related to preexisting conditions.

As I wrote then, the decision gave Republicans a chance to make good on their campaign promises to introduce legislation to maintain those protections even if the rest of the law is struck down (which invites a host of other problems, including how to pay for all those sick people). But no such legislation has been introduced.

Democrats are casting the vote to confirm Readler as another example of Republicans’ double talk on the issue. Minority Leader Charles E. Schumer (D-N.Y.) called it “an amazing act of hypocrisy.”

“You see, in the Trump administration, depriving people of protections [for] preexisting conditions is actually something to be rewarded,” Schumer said. “Shame. Shame on the Trump administration. Shame on anybody who votes for Mr. Readler, particularly those who claim they want to protect preexisting conditions.”

So far, Sen. Susan Collins (Maine), who has voted in the past against repealing the ACA, is the only Senate Republican to say publicly that she will not support Readler’s nomination.

“Rather than defend the law and its protections for individuals with preexisting conditions — such as asthma, arthritis, cancer, diabetes, and heart disease — Mr. Readler’s brief in Texas v. United States argued that they should be invalidated,” she said in a statement. “Given Mr. Readler’s role in the government’s failure to defend provisions under current law that protect individuals with preexisting conditions, I will oppose his confirmation to the bench.”

Democrats have been critical of Republicans’ efforts to stack the courts with conservative-minded judges, but they’re taking a particularly hard stance on Readler based on his recent history advocating against the ACA. Only 11 circuit court positions out of 167 total are vacant, and Republicans are eager to fill all those slots with their picks.

“I think right now the committee is working to put them out on the floor, and as soon as they come to the floor the leader’s making a priority to move them, so it will be a high priority for the foreseeable future,” Sen. John Thune (R-S.D.) said. “It’s one of the things we can do that we don’t have to have the House’s help with.”

The nominations are high priority for the Senate GOP and the Trump White House because once confirmed, judges are there for life. Notably, not only are the Republicans putting up nominees with an ideological bent, but the nominees are also noticeably younger, thus guaranteeing a decades-long placement of conservative judges.

Readler is 46. Allison Jones Rushing, who worked for the Alliance Defending Freedom, a conservative Christian organization, and is also up for a vote this week, is 36.

Erica Werner contributed to this report.