Fifth GOP senator announces opposition to healthcare bill

Sen. Dean Heller (R-Nev.) announced Friday that he is opposed to the Senate GOP’s ObamaCare repeal bill in its current form, making him the fifth GOP senator to come out against the plan.

“I’m announcing today that in this form I will not support it,” Heller said during a press conference.

Appearing alongside Nevada Gov. Brian Sandoval (R), who has been protective of ObamaCare’s Medicaid expansion, Heller raised concerns about the bill’s phaseout of the expansion.

“It’s going to be very difficult to get me to a yes,” Heller said.

Heller, the most vulnerable GOP senator up for reelection next year, raised doubt about whether he would support any phaseout of the federal funds for Medicaid expansion, even over a longer timeline, as some other moderate GOP senators favor.

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“You have to protect Medicaid expansion states. That’s what I want,” he said.

With Heller appearing to be a strong “no” vote, Senate Majority Leader Mitch McConnell (R-Ky.) and GOP leaders have their work cut out for them as they aim to pass healthcare legislation next week.

Republicans have a slim 52-48 majority, so they can afford to lose only two votes, assuming Vice President Pence breaks a tie.

Complicating the challenge for McConnell, objections to the bill are coming from both sides of the ideological spectrum. Conservative Sens. Rand Paul (Ky.), Ron Johnson (Wis.), Mike Lee (Utah) and Ted Cruz (Texas) are also opposed to the current bill, but moving the legislation in their direction could cause centrists like Heller to abandon it.

Paul, in particular, is seen as a likely “no” vote once the bill hits the floor.

Heller’s criticism Friday could indicate his vote is already out of reach. 

He sharply criticized many core aspects of the Senate bill that will be difficult for GOP leaders to change.

“This bill would mean a loss of coverage for millions of Americans,” Heller said, adding that it would also do nothing to lower premiums. 

Aside from wanting to protect the federal funding for Medicaid expansion, Heller also criticized a new cap on overall Medicaid spending in the bill, warning that the growth rate would result in cuts that are too deep. 

That low growth rate, though, is a key feature for conservative senators, again showing how hard it will be for GOP leaders to strike a balance. 

Heller also criticized waivers that would allow states to repeal ObamaCare’s essential health benefits, which govern which health services an insurance plan must cover. 

Those waivers are key to conservative support, and in fact conservatives are pushing for them to be even stronger, to allow states to repeal more regulations. That is the opposite direction from what Heller wants.  

But pulling the bill towards Heller is likely to further alienate conservatives already opposed to the plan.

“I can see the other side’s going to have problems” if Medicaid expansion is protected, Heller said of the conservatives, referring to “the Ted Cruz’s and Mike Lee’s and some of them.”

Updated: 4:01 p.m.