Nevada Sen. Dean Heller said at a news conference Friday afternoon that if the current draft of the Republican health care bill were brought to the Senate floor, he would vote “no.” That makes him the fifth senator to say so, the other four being Texas Sen. Ted Cruz, Kentucky Sen. Rand Paul, Wisconsin Sen. Ron Johnson, and Utah Sen. Mike Lee. Heller is the first, however, to oppose the current bill from a moderate policy perspective.
Heller is the most politically endangered Republican senator in 2018, by some distance. He represents one of the few swing states where Democrats have their act together. Further complicating the issue for him is Nevada’s Republican Gov. Brian Sandoval, an outspoken supporter of the Affordable Care Act’s Medicaid expansion. Sandoval introduced Heller at the press conference with remarks explaining how the Senate bill would lose Nevada hundreds of millions of dollars to cover its low-income population. Sandoval is a very popular governor.
Heller left some wiggle room to eventually support the bill. But it didn’t sound like a simple carve-out or boost in spending to one area or another could win him over.
“It’ll be very difficult to get me to a ‘yes,’ ” Heller said. He noted that there “isn’t anything in this bill that would lower premiums,” and that to say otherwise would be a “lie.” He said he wouldn’t vote for a bill that that "takes insurance away from tens of millions of Americans," which is sort of the bread and butter of Republican health policy. It did not sound like a lengthier phaseout of the Medicaid expansion would satisfy Heller the way it might satisfy, say, Ohio Sen. Rob Portman. He would want Obamacare's Medicaid expansion more or less preserved.
It is hard to see right now what could be done to appease him. This press conference may have been Heller laying claim to one of the two lifeboats that Senate Majority Leader Mitch McConnell can spare in order to get to 50 votes. I don’t think this kills the bill: Heller is the single most deserving of a lifeboat of any Republican senator, given his re-election circumstances, and McConnell may well have given him the nod to go ahead with this statement. McConnell might have preferred that he temper his criticism a bit, though.