Nevada Republican Dean Heller didn’t mince words about the GOP’s new health care bill in the Senate: “It’s going to be very difficult to get me to a yes.”

Speaking at a press conference in his home state Friday, Heller was the first Republican senator to come out swinging against the Better Care Reconciliation Act, while at least seven others have expressed reservations but indicated they’re open to negotiations. Heller’s seat is up for reelection next year, and a Democrat won Nevada’s other Senate seat by a 2.4 percent margin in 2016. Hillary Clinton won the state by 2.4 percentage points, or 27,272 votes.

Appearing next to Nevada Gov. Brian Sandoval, also a Republican, Heller announced his opposition to the legislation, highlighting the Better Care Act’s proposed substantial cuts to Medicaid.

“[The Better Care Act] takes insurance away from tens of millions of Americans and hundreds of thousands of Nevadans,” Heller said, echoing a sentiment expressed in his initial statement on the bill, when it came out Thursday. “There isn’t anything in this bill that would lower premiums.”

In addition to Heller, Republicans expected to offer some pushback against the Senate bill include Maine’s Susan Collins and Ohio’s Rob Portman. More hard-line members of the party, including Ron Johnson, Mike Lee, Ted Cruz, and Rand Paul, have said the legislation doesn’t go far enough in its sweeping cuts to Medicaid, insurance subsidies, and taxes on the rich.

While the conservative senators are ultimately expected to vote for the bill, Heller is a much harder no, and if he gets his way, it will be tough to create a compromise that works for the minimum number of Republicans required to pass the bill.