Sen. Dean Heller (R-Nev.) holds a news conference Friday in Las Vegas to announce he will vote no on the proposed GOP health care bill. | Erik Verduzco/Las Vegas Review-Journal via AP Heller comes out against Senate GOP health care bill The Nevada Republican did leave the door open to supporting the bill if changes are made.

Sen. Dean Heller said Friday that he won't support the Senate's Obamacare repeal bill without significant changes to prevent major coverage losses, a potential blow to the GOP efforts to roll back the health care law.

“This bill that’s currently in front of the United States Senate is not the answer. It’s simply not the answer,” said Heller, the most vulnerable Senate Republican in the 2018 midterm election. “It’s going to be very difficult to get me to a yes."


Heller is now the fifth Republican to go public with a threat to vote against the bill, which is the culmination of seven years of GOP campaign promises. On Thursday, four conservatives — Sens. Rand Paul, Ted Cruz, Mike Lee and Ron Johnson — said they aren’t ready to support the draft bill because it preserves too many of Obamacare's regulations but said they’re open to negotiations. Senate Majority Leader Mitch McConnell can lose only two of his 52 members for the bill to pass when he holds a vote in a week.

Shortly after Heller's announcement, America First Policies, a group started by some of President Donald Trump’s campaign advisers, said it would launch an advertising blitz against Heller for his opposition.

Heller did leave the door open to supporting the bill if changes are made.

"Both Republicans and Democrats can agree the [Affordable Care Act] does need some fixes," the Nevada Republican said. But he said he wouldn't support rolling back Medicaid unless payment rates for a state like Nevada are boosted.

"This is all about Medicaid expansion. ... You have to protect Medicaid expansion states,” Heller said.

However, he acknowledged that conservatives will oppose his request to expand funding, pointing to “the Ted Cruzes and Mike Lees and them because they’re not in expansion states,” he said.

Heller made his remarks in Las Vegas, standing next to Gov. Brian Sandoval, a moderate Republican who defied party orthodoxy to set up an Obamacare exchange and expand Medicaid and who strongly opposes repeal of the ACA.

POLITICO Pulse newsletter Get the latest on the health care fight, every weekday morning — in your inbox. Email Sign Up By signing up you agree to receive email newsletters or alerts from POLITICO. You can unsubscribe at any time. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

For that reason, the law’s rollback of Medicaid expansion — as well as major cuts and restructuring of the entire program — have become huge issues in Nevada. More than 200,000 Nevadans are covered through the Medicaid expansion, and nearly 90,000 people signed up for Obamacare plans through its exchange.

Heller told several reporters in the Capitol earlier this month that he would support phasing out the Medicaid expansion over seven years. But his office later pushed back on that statement to local reporters.

Heller has previously said that he would vote based on what he determined to be the best interests of his state.

“The current bill as written is something that needs to change,” said Sandoval, who is term-limited in 2018. “I think we can do better.”

America First Policies is readying more than $1 million in anti-Heller ads, according to a source familiar with the planning. For the group, the ad blitz is an opportunity to show that groups aligned with Trump’s base are ready to go to bat for the president.

"You do not want to mess with Donald Trump’s base in a primary, particularly in a place like Nevada,” said the source. “This kind of money in Nevada is real. … This is a beginning.”

The ad campaign, which features digital, TV and radio components, will paint Heller as a “typical politician,” the source said, and will characterize him as standing with Democratic leaders Chuck Schumer and Nancy Pelosi against the White House. The source said America First views Heller as more solid in his opposition than the other Republicans who have come out against the Senate bill.

But Heller has backup in Nevada. Sandoval issued a statement immediately following the release of the Senate bill Thursday saying its contents caused him “great concern.”

He also recently penned a letter, along with six other governors (two other Republicans and four Democrats), urging Congress to prioritize fixes that would stabilize the individual market, rather than making major changes to Medicaid that would end the program as an open-ended entitlement.

