Sen. Dean Heller is trying to walk a fine line on ObamaCare ahead of his tough reelection race next year.
The Nevada Republican, considered the most vulnerable GOP senator in the 2018 midterm reelections, is under attack from both the right and the left and is trying to stake out a middle ground.
Democrats are hammering him for his vote in favor of a scaled-down repeal bill, but his Republican primary challenger, Danny Tarkanian, argues that bill did not go far enough. He said Heller should have supported a more sweeping repeal, which Heller had rejected earlier in the debate.
Heller argues that he sought a balance with his actions.
The “skinny” repeal bill did not touch ObamaCare’s expansion of Medicaid, a critical issue in Nevada. The larger repeal bill could have had devastating consequences for his constituents, he said.
“I voted for the skinny bill that did not touch Medicaid,” Heller said at an appearance in Nevada on Wednesday in which he sought to explain his votes.
He claimed GOP leaders left Medicaid untouched in the skinny bill because of his concerns.
“There’s only one reason why Medicaid was kept in that final version and that was because of me,” he said.
It’s true that Senate GOP leaders moved to the slimmed-down bill because they could not win 51 votes on broader legislation, though this was the result of opposition from several Republican senators.
Jon Ralston, a leading Nevada political expert and editor of The Nevada Independent, said Heller had only confused constituents with his shifting stances on ObamaCare repeal.
“The only consistent thing about Dean Heller on healthcare is his inconsistency,” Ralston said. “He has managed to alienate both the left and the right and confuse the middle.”
As a result, Ralston said Heller is vulnerable in a primary where Republicans voters may seen him as insufficiently loyal to President Trump, and in the general election.
Still, Ralston says Heller should not be counted out.
“He finds a way to survive,” he said, though he added that “his numbers are terrible.”
A poll from the left-leaning Public Policy Polling, released early this month in the wake of the ObamaCare repeal vote, found Heller’s approval rating was just 22 percent, with 55 percent disapproving.
Democrats are planning to make Heller’s position on healthcare a central part of the campaign.
“I believe that people feel Dean Heller has betrayed them in the state,” Rep. Jacky Rosen (D-Nev.), who is running against Heller, said in an interview.
She and other Democrats say his vote for skinny repeal was a step away from the opposition to repeal promised during a high-profile June press conference with popular Nevada Gov. Brian Sandoval (R), who opposed the skinny bill.
At the press conference, Heller said that he would not support legislation “that takes insurance away from tens of millions of Americans and hundreds of thousands of Nevadans.”
Yet Democrats note that the skinny bill would have left 16 million fewer people with insurance.
Heller counters that most people who lose insurance from the skinny bill would have done so by choice once the mandate to buy insurance is repealed, according to the Congressional Budget Office’s analysis.
“The numbers that came out of CBO, they will tell you this, that the 16 million people that will lose their healthcare over the next 10 years are 16 million people that don’t want to buy this product,” Heller said at the event Wednesday.
Democrats also argue that Heller did not really protect Medicaid, because by voting for skinny repeal, he voted to keep the repeal process alive, and the measure that came back from negotiations with the House very well could have contained Medicaid cuts.
In addition, Heller is now supporting a new ObamaCare replacement bill, cosponsored by Sens. Bill Cassidy (R-La.) and Lindsey Graham (R-S.C.), that would restructure Medicaid expansion in what Democrats say would lead to harmful cuts.
As Heller responds to the attacks from the left, he must also watch his right flank.
“He acts like that’s a repeal of ObamaCare; it’s not,” Tarkanian told The Hill, referring to the skinny bill.
Tarkanian won some support from the right on Thursday with the endorsement of 2008 Republican vice presidential nominee Sarah Palin. Trump, though, has not yet backed a candidate in the race, taking a more hands off approach so far than he has in Arizona’s race, where he is taking aim at Sen. Jeff Flake (R-Ariz.) in the GOP primary.
Heller says he has been consistent in protecting Medicaid and seeking to end ObamaCare’s mandate that people buy insurance.
“Throughout the health care debate, I made it clear that it was important to preserve coverage for Nevada’s most vulnerable and provide relief to many hardworking Nevadans by repealing the most onerous provision of Obamacare, the individual mandate, and that is the way I voted,” Heller said in a statement to The Hill.
“We need solutions for Nevadans, not partisan fights and that’s why as a member of the Senate Finance Committee, which has jurisdiction over health care, I look forward to working with my colleagues on bipartisan solutions to improve our broken health care system.”
Democrats say Heller’s argument that he does not want to touch Medicaid is undercut by his support for the Graham-Cassidy bill, which would have effects on Medicaid.
The bill would take dollars spent on ObamaCare and give them to states in a block grant. That could have profound effects for Medicaid expansion, because states would be getting a block grant instead of their current Medicaid expansion funding from the federal government. That could lead to cuts if the block grant does not grow fast enough to keep up with spending needs.
Heller says the Graham-Cassidy bill would help Nevadans, resulting in $643 million more healthcare spending in a year in Nevada compared to ObamaCare, according to calculations from his office.
However, Democrats point to a
“The new bill that his name is on wants to cut Medicaid funding,” Rosen said.