During an interview with a conservative radio host earlier this year, Rep. Dave Brat, R-Va., connected a spate of mass shootings to “elites up in D.C.,” suggesting that national leaders could do nothing to stop the violence and were, in fact, exacerbating it through the Affordable Care Act.

Brat was being interviewed in August by Virginia radio host John Fredericks, who told the congressman he was concerned about young men resorting to gun violence as his son entered high school a day after a 24-year-old allegedly shot and killed two people at a video game event in Jacksonville, Fla.

“I look at this video shooting in Jacksonville. And there’s just been a number of these. And they’re all young men, right? They’re not daughters, they’re sons,” Fredericks said. “Am I overreacting? Is this a fatherhood problem, Dave? What is going on?”

Brat, who is in a difficult re-election race against Democrat Abigail Spanberger, a former CIA counterterrorism officer, replied that it was a “giant cultural piece.”

“It just fits into the overall narrative, right? We’re trying to run the country through elites up in D.C. across the board,” Brat said.

Brat then brought up the opioid epidemic and the Affordable Care Act in the same vein, asserting that large scale problems should be dealt with on the local level.

“Instead of having the elites try to run and solve all of these, you know, through connections that you have down in the localities up in D.C.,” Brat said. “It just does not work. And I think Obamacare is just kind of the emblematic piece there.”

He blamed those “elites” for the “couple hundred million lethal doses of fentanyl coming across the border, the heroin problem, the opioid problem, the trafficking problem, family breakups, depression — mental health is discouraged in the schools right now across the country. And you put all that together and you’ve got some major social problems.”

Medical and addiction treatment experts take the opposite view, warning that repeal of the Affordable Care Act would deal a severe blow to efforts to address opioid addiction and fight the growing crisis as well as treat mental illness.

Recently a Richmond radio station recorded Brat telling a recovering addict: “You think you’re having a hard time—I’ve got $5 million worth of negative ads coming at me. How do you think I’m feeling? Nothing’s easy. For anybody.”

After 11 people were shot to death Saturday at the Tree of Life synagogue in Pittsburgh, Brat tweeted: “Deeply saddened by news of the murderous attack on the Tree of Life synagogue in Pittsburgh today,” adding a quote from the Rev. Martin Luther King Jr.

On Tuesday, Brat attended a vigil for the victims at the Weinstein Jewish Community Center in Richmond.