In Florida, HIV Advocates Warn That a Blue Wave Might Fall Short

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Over the years, the state of Florida has earned a political reputation as a place whose electoral future is difficult for pundits to predict and whose electorate is notoriously hard for progressives to reach. Despite having a larger percentage of Latinx residents than any other state east of the Mississippi and a black population larger than that of any other traditional "swing states," Florida has remained a stronghold for the Republican Party and proved a frustrating mirage for Democratic candidates in recent years.

Unfortunately for Democrats, it appears as if the blue wave that is supposed to be sweeping across the United States in the 2018 midterms might crest and peter out before it hits Florida. While a couple of House seats currently held by Republicans in South Florida are likely to flip Democratic in 2018 (including Florida's 27th Congressional District, which is now up for grabs following the retirement of Ileana Ros-Lehtinen, the Republican co-chair of the Congressional HIV Caucus), the political environment across the state as a whole isn't looking too promising for progressives. Of all of the battleground states he won during the 2016 election, President Trump has his highest net approval ratings in Florida and, in a year when a generic Democratic candidate is beating a generic Republican by roughly eight points at the national level, Floridians could very well vote out the only Democratic official currently elected to statewide office.

In a crucial U.S. Senate race in Florida between the current Republican governor, Rick Scott, and the incumbent Democratic senator, Bill Nelson, Scott holds a slight lead over Nelson in the polls. Nelson, a moderate Democrat who is seeking his fourth term in office, has kept his traditionally low profile, failing to capitalize thus far on the surge in advocacy and electoral engagement among progressives in other parts of the country. However, how much of that failure is due to Nelson's understated campaigning strategy and how much is the result of Florida's peculiar political makeup is unclear, according to AIDS service providers in the state.

"We just haven't seen a huge surge in grassroots advocacy in Florida," said Priya Rajkumar, chief operating officer for Metro Wellness & Community Centers in Tampa Bay. "The state's diehard Republican past stifles activism."

Metro Wellness, an AIDS service organization that says it serves 6,000 people living with HIV in the Tampa area and is currently the number two pre-exposure prophylaxis (PrEP) provider in the state, knows all too well the negative consequences of having Republican representation in Congress and in the state government in Tallahassee. Thanks to the anti-Affordable Care Act policies of Governor Scott and the overwhelmingly Republican state legislature, Florida has rejected Medicaid expansion policies that would provide health care for 660,000 currently uninsured, low income residents, many of whom are either living with or at risk of contracting HIV. Nationwide, 42% of people living with HIV who are actively in care are enrolled in Medicaid, a number that jumped six percentage points from pre-ACA levels. Unfortunately, that increase happened in spite of Medicaid expansion being rejected in states in the Deep South where the HIV epidemic is most severe.

Florida, which has the third highest HIV diagnosis rate among U.S. states, is in desperate need of a shakeup in leadership and, while long-tenured politicians such as Nelson aren't sparking much enthusiasm, the young, dynamic, Democratic nominee for governor is making waves.

Related: The Consequences of Our Elections: Why The Midterms Matter to People Living With HIV

In August, 39-year-old Tallahassee Mayor Andrew Gillum stunned the Florida political establishment by winning the Democratic gubernatorial primary, defeating former U.S. Representative Gwen Graham (D-FL2) in a race that garnered a great deal of interest from both local and out-of-state progressives, earning endorsements from Senator Bernie Sanders (I-VT) and former Secretary of Housing and Urban Development Julian Castro. If elected, Gillum would be the first black governor of the state of Florida and the first black governor of a state in the Deep South since Reconstruction. Whether his election would fundamentally change life for the nearly 136,000 Floridians estimated to be living with HIV and the hundreds of thousands of others at risk of contracting HIV is less certain.

"There would be so many changes with a Democrat in the Governor's Mansion." Rajkumar told TheBody. "With that being said, the politics in the state of Florida have been so conservative for so long, it's hard to see all of that changing with one person. It's really hard to shift that culture, but it would make for a great internal shift in government, though. The changes in the state Department of Health would be huge."

In just six weeks, we should know whether these changes are imminent or whether Floridians have instead elected another Republican to lead their state, this time around in the form of the Trump-backed, nakedly racist Ron Desantis.

To keep up on what's going on with the midterm elections in Florida and across the country, check in with TheBody's election center from now through Nov. 6.