Senator Dean Heller of Nevada became the latest Republican to say he cannot support a bill to repeal the Affordable Care Act in its current form.
WASHINGTON — Senator Dean Heller of Nevada, perhaps the most vulnerable Republican facing re-election in 2018, said Friday that he would not support the newly released Senate health care overhaul as written, dealing a serious blow to his party’s attempt to repeal the Affordable Care Act just days before a showdown vote.
Using remarkably caustic language, Mr. Heller, who is seen as a pivotal swing vote, denounced the Senate-drafted bill in terms that Democrats swiftly seized on. He said the measure would deprive millions of health care and do nothing to lower insurance premiums.
“I cannot support a piece of legislation that takes insurance away from tens of millions of Americans, ” he said at a news conference in Las Vegas, standing next to Nevada’s Republican governor, Brian Sandoval, who accepted federal funding in the health law to expand Medicaid .
After vowing for the last seven years to tear up what they call Obamacare, congressional Republicans and President Trump are under pressure from their conservative base to fulfill their campaign trail promises. But Republican lawmakers in swing states face an excruciating choice: risk angering their grass-roots supporters by walking away from the repeal effort or expose themselves to ferocious Democratic attacks by pushing through a deeply unpopular bill.
So far, five Republican senators have said they cannot vote for the Affordable Care Act repeal as written: Mr. Heller, whose concerns are with the bill’s benefit cuts, and four hard-line conservatives who say the bill is too generous.
Mr. Heller did not rule out ultimately voting for a version of the bill, leaving the battle for 50 votes ahead of a Senate showdown still very alive. But his denunciation of what is one of the pillars of President Trump’s agenda gave fresh hope to Democrats that they may be able to torpedo the measure.
And it offered a needed morale boost to the Democratic Party after a trying week full of recriminations about why they lost a special congressional election in Georgia on Tuesday, the latest in a series of demoralizing defeats they have suffered this year.
“It’s an all-hands-on-deck moment, ” said Anna Galland, the head of MoveOn. Org, an advocacy group firmly on the liberal wing of the party. “We are unified out of urgent, building-is-burning-down necessity. And health care is by far our top priority.”
Scrambling to halt or at least slow the Senate’s repeal effort, a range of Democratic and progressive leaders said Friday that they intended to intensify pressure on Republican lawmakers.
Liberal groups have already organized protests against the bill, and Senator Bernie Sanders, independent of Vermont, plans to lead a campaign-style tour this weekend through West Virginia, Pennsylvania and Ohio, three states with Republican senators that also expanded Medicaid under the Affordable Care Act. Planned Parenthood, which would be defunded under the Senate bill, has been running television ads targeting Mr. Heller, as well as Senators Jeff Flake of Arizona, also up for re-election next year, and Shelley Moore Capito of West Virginia.
And in recent days, potential Democratic challengers have stepped forward against both Mr. Heller and Mr. Flake, the two Republicans most likely to face tough races in 2018. In Nevada, Representative Jacky Rosen has signaled she is likely to run against Mr. Heller, and Randy Friese, an Arizona state representative and trauma surgeon, said he is leaning toward challenging Mr. Flake. Phoenix Mayor Greg Stanton, who is a Democrat, is also believed to be considering a campaign.
Senate Republicans crafted their bill behind closed doors, drawing considerably less news attention than House Republicans who formally drafted their version of the legislation in open sessions. But Democrats believe the coming week represents their best and perhaps final chance to thwart repeal of the health law.
“This is the one opportunity we have to shine a light on this legislation, and we will do it day and night, ” said Senator Chris Van Hollen of Maryland, projecting the bill’s passage “a jump ball.”
The Senate Democratic campaign arm, which Mr. Van Hollen chairs, plan to increase its spending this week on internet ads focused on the health measure in Nevada and Arizona, as well as Texas and Florida, which also have Senate races in 2018. The Democratic Senatorial Campaign Committee is just one of a series of liberal groups that are airing spots — online and on television and radio — to pressure up-for-grabs Senate Republicans into opposing the overhaul.
Senators Lisa Murkowski of Alaska and Susan Collins of Maine, two centrist Republicans who at times defy their party, are also facing intense lobbying to vote no.
Strikingly, there has been little in the way of advertising from the right pushing Republicans to support the bill. But Mr. Heller’s criticism Friday infuriated allies of Mr. Trump. America First Policies, a super PAC aligned with the White House, was gearing up to spend $1 million worth of advertising in Nevada aimed at making him change his mind, according to a person familiar with the group’s plans.
Indeed, Mr. Heller may best reflect the tensions within the larger Republican Party. He is a popular but vulnerable lawmaker from a purple state that is full of rural conservatives but is increasingly shaped by a rising minority population in and around Las Vegas, its population center. And while Mr. Heller has called for repealing the Affordable Care Act — a promise that thrills the Republican base — he has also, like many of his colleagues, consistently reassured voters that their health coverage would improve under a Republican alternative.
A number of Mr. Heller’s colleagues who fit that broad description could face backlash down the line, in 2020 or beyond, if they vote for a bill that proves deeply unpopular as a matter of law. Along with Mr. Sandoval, several other Republican governors have voiced similar criticism of the bill, including Charlie Baker of Massachusetts, Larry Hogan of Maryland and John Kasich of Ohio.
Mr. Kasich shares a home state with Senator Rob Portman, a Republican who was just re-elected to a second term in November, and has not yet taken a stance on the Senate legislation.
Standing with Mr. Heller, Mr. Sandoval offered a robust case for protecting those who have received insurance under the Medicaid expansion — an effort that could prompt some Senate Republican hard-liners already uneasy about the bill to walk away.
“These are our friends. These are our families. These are our neighbors, ” Mr. Sandoval said of the 210,000 Nevadans who obtained Medicaid coverage under the Affordable Care Act.
