The list of GOP senators unhappy with the initial draft of the Republican health care bill continues to grow. Before Senate Majority Leader Mitch McConnell (R-Ky.) decided to postpone the vote, six GOP senators announced they would vote against it. Since then, that number has doubled.

Due to McConnell’s pushback, the Senate will not vote on the bill until after the July 4 recess. With the GOP’s slight 52-person majority in the Senate, and no Democrats expected to vote in favor, only three Republicans have to be against the bill for it to fail. As of June 30, the following Republican senators have expressed concerns with the first draft of the bill:

Data from the Center for Responsive Politics shows that from 2012 to 2016, a majority of these names were not very popular among donors within the health care industries. These industries include health insurance and HMOs; health professionals; hospitals and nursing homes; health services; and pharmaceuticals and health products. Eight of the 12 senators received less than $1 million. However, donors did give more than $2.1 million each to Portman and Cassidy, putting them both in the top 10. As for the other senators on this list, their average donation total over the four-year span was just under $693,000.

In comparison, McConnell, who has been leading the charge on the Senate health care bill, topped the 2012-16 list with almost $3.7 million in donations.

While the data is not yet available to see what these senators may have received in donations from the health care industries since the bill was released, in April and May of this year very little money was given to these senators, including McConnell. Heller received the most from the health care industries with $26,500. Trailing him were Cassidy with $8,500; Sasse with $7,500; Portman with $3,000; Moran with $2,500; and Capito with $1,500. The rest reported either zero money or, in Collins’ case, a net return of $2,500.

Although many of these senators were critical of the health care bill, not all of them were solid “no” votes before McConnell’s delay. Capito, for example, had concerns about the bill, but until the vote was pushed back, she hadn’t expressed an explicit decision. Almost immediately after McConnell’s announcement, though, Capito sent out a series of tweets about the health care plan, saying she couldn’t support it. Capito and Portman issued a joint statement explaining why they did not back this draft of the Senate health care bill.

When the health care draft was first released, Cruz, Johnson, Lee and Paul gave a joint statement against the legislation. In his own individual statement, Cruz cited the bill’s not-low-enough premiums as one of the reasons he would vote no. Additionally, the Medicaid cuts in the Senate’s plan were big concerns for Collins and Heller. Heller’s state of Nevada is one of the states that has benefited significantly from the Medicaid expansion under the Affordable Care Act.

Heller in particular was targeted by America First Policies–a 501(c)(4) social welfare organization run by allies of the administration–for his opposition to the health care bill. The group — which is run by several people who were on Donald Trump’s 2016 presidential campaign team — called out Heller on Twitter and planned a series of attack ads against the Nevada senator and his decision to oppose the legislation.

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Dan Lee, an assistant professor of political science at the University of Nevada, Las Vegas, said he’s not sure why America First Policies chose to do this because “in a lot of ways Heller is the kind of Republican you wouldn’t want to attack.”

After being scolded by Republican politicians, like McConnell, for the blitz, America First Policies quickly retracted the ad, which ran for about half a day in Nevada. After the organization pulled their ad, their spokesperson, Erin Montgomery, said in a statement they were glad to see Heller was open to negotiations on the bill.

Lee said the group most likely saw Heller’s “no” as more firm than the other senators and chose to focus on him in order to get the bill passed. He added that this tactic fits with the more aggressive posturing Trump himself has shown.

No matter the reasoning for the attack ads, this series of events highlights the trouble Heller is in, Lee said. As one of the most vulnerable incumbents in the 2018 congressional election, Heller has a difficult road ahead. For his reelection, does he appeal to Republican voters or try to sway independents and moderates? For the health care bill, does he vote against it to protect his constituents and their reliance on Medicaid or does he vote “yes” to give Senate Republicans the win they need?

“If he wavers in between, everyone will have an excuse not to like him,” Lee said. “Heller needs to pick a side and go with it.”

In addition to the ad against Heller, America First Policies has also produced several ads attacking Democratic senators for being against the health care bill. All of these Democrats, except for Sen. Tim Kaine (Va.), are from states Trump won in 2016. The ads were almost the same for each senator, with the only change being the name and photo of the politician.

Only time will tell how much this political attack will hurt Heller or the health care bill, said David Damore, a professor of political science at the University of Nevada, Las Vegas. No matter what, he added, it’s going to be hard for the Nevada senator to vote “yes” on this bill.

“The problem for him will be if it still passes, even with his ‘no’ vote,” Damore said. “He could be blamed for not doing enough to stop it. Heller can only hope it all falls apart.”



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