Health care legislation is hanging by a thread in the Senate, and no one is under more pressure than Republican Sen. Dean Heller of Nevada.
Heller was already seen as the most endangered GOP incumbent senator in next year’s midterm elections. He is the only one running for re-election in a state President Donald Trump lost to former Democratic presidential candidate Hillary Clinton.
Against that backdrop, it’s hard to envision a more difficult political choice for Heller than whether to support the health legislation expected to come to a vote next week in the Senate. There are already two GOP senators opposed to the legislation, so one more “no” vote would kill the bill outright in a Senate divided 52-48 between Republicans and Democrats.
Over the next several days Heller must decide whether to defy Trump and Senate Majority Leader Mitch McConnell by becoming that third “no.”
Yet if he sides with the president and Senate leader and supports the bill, Heller would likely be parting ways with Nevada’s popular GOP Gov. Brian Sandoval, who has already expressed deep concerns about the legislation’s cuts to the Medicaid program for the poor and disabled.
For Heller, it looks like a no-win situation.
“There is no sweet spot in health care,” said Heller’s fellow Nevada Republican Rep. Mark Amodei. “So if somebody’s looking for it, they’re going to be a pretty frustrated person.”
The normally affable and low-key Heller had no announced public events Friday, and a spokeswoman did not respond to requests for comment. On Thursday Heller released a terse statement saying that “Conversations are continuing and I’m going to read the new bill and weigh its impact on Nevada.”
After Heller announced his opposition to the initial bill in June, a group linked to Trump launched a hard-hitting ad campaign against him. From the other side Democratic groups have already signaled they will use the issue against him in his re-election campaign, a fate Heller probably can’t escape no matter how he votes.
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The immediate heat, though, is on Heller, who faces a tough 2018 election where his decision next week will surely be a defining moment.
Outside Heller’s Las Vegas office I met a handful of activists who planned to go inside to make their case.
“Urge him to stay strong, to vote no,” said Cyndy Hernandez. “There are reports that Republicans think they can make a deal with him.”
That news came from the website Axios, where reporter Mike Allen said Friday morning, “Republicans keep telling me Sen. Dean Heller of Nevada, a third apparent ‘nay’ will be ‘bought off.’”
Heller’s office had no comment Friday.
Heller, in other words, has backed himself into a corner. Either he honors the concerns he raised just a few weeks ago, or reverses course and completes a very public betrayal – the year before his re-election campaign.
Heller faces a fierce reelection fight in 2018, and is already feeling pressure from Nevada Gov. Brian Sandoval to resist attempts to roll back funding for the state’s Medicaid expansion—two factors that have fueled speculation he’ll be the crucial third Republican to oppose the bill. But after blasting the Senate’s initial repeal bill, he’s softened his stance on the latest legislation, saying only that he remains undecided.
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As my colleague Jonathan Chait explains, Republicans are sounding confident that they can “buy” the remaining “moderates,” with the toughest case being Dean Heller of Nevada.
For the GOP “moderates,” the question will become: Exactly how many millions of people losing health insurance is acceptable? Dean Heller has said he cannot vote for a bill that will cause “tens of millions” to lose coverage. Does that mean 15 million is okay? How about 19 million? If Heller is, indeed, waiting for an offer from McConnell he can’t refuse, then he’d better prepare an answer to that question which he can square with his earlier comments.
But of all the senators on the fence, Heller appears to be the most important. He is the only skeptic up for reelection in 2018. And in a state that went for Hillary Clinton in November, he is perhaps the most vulnerable Republican in the entire Senate.
There is nothing in the new Senate bill to suggest that it would prevent more Americans from losing their health insurance, though senators may not have an official score from the nonpartisan Congressional Budget Office to confirm its exact impact one way or another. Nor is there any reason to believe it would lower insurance premiums, another concern of Heller’s.
So it was surprising Thursday when Heller, sneaking out a backdoor from McConnell’s office, told reporters staking out the meeting that he was “undecided” after “very, very good” conversations with McConnell.
The Axios report said Republicans believe Heller’s support could be purchased with a few goodies, and that could be the key for passing this Senate health care bill.
That Heller isn’t rushing out to announce his opposition, perhaps even sending McConnell back to the drawing board, could be an indication that he either wants this effort to fail, or that this bill is truly about to pass.
Heller’s office did not respond to a request for comment.