An orange inflatable tubeman with yellow hair meant to represent Republican Sen. Dean Heller goes to the doctor’s office in a new ad released by Democratic Rep. Jacky Rosen that begins airing Friday.

In the new 30-second spot, a doctor displays an x-ray and tells the tubeman, which has appeared in several of Rosen’s prior ads, that he has identified the problem: “You have no spine.” The doctor then highlights Heller’s changing positions on repealing and replacing the Affordable Care Act, including standing alongside Gov. Brian Sandoval saying that he wouldn’t vote in favor of a motion to proceed on the House’s repeal and replace bill before voting to do just that a little more than a month later.

The doctor also plays a clip in which President Donald Trump goads Heller over his waffling support for the legislation.

“You weren’t there. But you’re gonna be, you're gonna be,” Trump says.

The doctor then says that Heller “broke [his] promise and voted for repeal,” including supporting raising rates for older people and taking away protections for pre-existing conditions. The bill that Heller voted in favor of opening up debate on would have allowed insurance companies to charge older people five times more than younger people buying on the individual market, and a proposal he later signed onto that would have block granted dollars from the Affordable Care Act to the states would have allowed states to waive the federal health care law’s requirements on pre-existing conditions.

“Senator Heller, stay away from Washington, okay?” the doctor says.

The ad is backed by a seven-figure buy and will air statewide.