Nevada Republican Gov. Brian Sandoval responds to reporter's questions about health care and the opioid epidemic after a session called "Curbing The Opioid Epidemic" at the first day of the National Governor's Association meeting July 13 in Providence, R.I. | Stephan Savoia/AP Photo Nevada governor undecided on health bill, will meet with Pence

PROVIDENCE, R.I. — Nevada Gov. Brian Sandoval on Friday expressed deep reservations about Senate Republicans’ latest Obamacare repeal bill, but he wouldn’t go as far as to say he opposes the revised legislation.

“My preliminary understanding is that, with regard to the Medicaid population, it is not any different or much different than the previous bill, which would cause me great concern,” Sandoval told POLITICO during the National Governors Association meeting in Rhode Island.


The moderate Republican said he will meet privately with Vice President Mike Pence, who will deliver a speech to governors later today. Earning Sandoval's support for the legislation is seen as crucial for securing a vote from Sen. Dean Heller, the most vulnerable GOP incumbent facing reelection next year.

The revised Better Care Reconciliation Act provides additional subsidies for people of lower income and makes tweaks to the GOP's Medicaid overhaul. But major cuts to Medicaid, the largest sticking point for several moderate Republicans, remain in the bill. Sandoval, who opposed the initial Senate bill, said the legislation's rollback of generous Medicaid expansion funding remains his biggest concern.

“I want to protect the 210,000 lives in Nevada that are living happier and healthier lives,” said Sandoval, adding he still needs to review the legislation with his staff. “That’s been my primary concern all along.”

Heller and several moderate Republicans from Medicaid expansion states — including Ohio’s Rob Portman, West Virginia’s Shelley Moore Capito and Alaska’s Lisa Murkowski — have not yet taken a position on the updated legislation.

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Two Republican senators, Susan Collins of Maine and Rand Paul of Kentucky, have said they will oppose a procedural measure to start debate on the bill. Senate Majority Leader Mitch McConnell cannot afford to lose another Republican vote.

Ohio Gov. John Kasich, one of the most outspoken Republican critics of the GOP repeal effort, blasted the updated bill on Friday morning and urged congressional leaders to strike a bipartisan compromise.

"The Senate plan is still unacceptable," he said. "Its cuts to Medicaid are too deep and at the same time it fails to give states the ability to innovate in order to cope with those reductions."

