What’s Next for Dean Heller After Health Care Votes?

Nevada lawmaker is the most vulnerable GOP senator

Nevada Sen. Dean Heller makes his way to the Senate chamber for a series of votes on repealing the 2010 health care law. (Bill Clark/CQ Roll Call)

Sen. Dean Heller’s vote to support a bill to repeal the 2010 health care law — while rejecting others — may make an already tough re-election campaign even harder.

The Nevada Republican was already facing pressure from voters on the left and the right, his own party’s leadership and the White House going into last week’s Senate health care votes. That’s not all going away just because the votes are over.

Liberal activists aren’t backing down. They canceled a Tuesday rally outside Heller’s Las Vegas office that was scheduled before Friday’s early morning health care vote. But they plan to hold events when Heller returns to Nevada later this month, one of the rally’s organizers said.

In the meantime, the activists say they are refocusing their strategy, shifting from persuading Heller to vote against the GOP bills to holding him accountable for his votes last week.

“We will let him know we’re not going to forget that he betrayed us on this vote,” said Andres Ramirez, Nevada director of the Save My Care coalition. 

Heller is the most vulnerable of the eight Republicans up for re-election next year. Inside Elections with Nathan L. Gonzales rates the race a Toss-up.

And last week’s health care votes could be a lose-lose situation for Heller, angering his conservative base as well as moderates and independents.

He has some explaining to do.

On the record

For weeks, Heller has been facing pressure from conservatives and Democrats alike as the Senate hurtled toward votes on health care. And he had been a bit of a question mark as the process moved forward.

“There’s no right vote for you on this at the end of the day,” said Zachary Moyle, a former executive director of the Nevada Republican Party. “You’re going to get hammered no matter how you vote.”

Standing next to Nevada’s GOP Gov. Brian Sandoval in June, Heller said he could not support the Republican plan that slashed Medicaid or the motion to proceed to that bill.

Nearly one month later, he told Axios that he still needed more information on the new options for the Republican bills. And he declined to outline the determining factors for his vote, besides saying he would do what was best for Nevada.

Four days later, Heller voted for the motion to proceed on the GOP health care bill, even though Republicans were not completely clear which plan they would be voting on.

Heller voted against the more comprehensive plan to repeal and replace the 2010 health care law, and against the bill just repealing the law, a measure he originally supported in 2015.

And in the early hours of last Friday, he voted for the so-called skinny repeal bill, which was the Senate GOP leaders’ last-ditch effort to pass something so they could get to conference with the House. Heller’s support came after three crossover votes by Republican Sens. John McCain, Lisa Murkowski and Susan Collins already torpedoed the measure.

A Nevada Democratic strategist said Heller’s vote to proceed to the debate would have already been an issue, but his skinny repeal vote was even worse.

“I think it is even more problematic for him now because he endorsed and voted for a specific plan that would have been a complete disaster,” the strategist said. “And he walked the plank for nothing.”

The Congressional Budget Office estimated that the skinny repeal bill would lead to 16 million more uninsured people, and premiums would increase by 20 percent.

Heller said in a statement explaining his vote that the skinny repeal bill was “not perfect,” but in his view, it protected coverage and provided relief through repealing the 2010 law’s individual mandate. He also said he’s ready to work on a bipartisan solution.

But some Nevadans aren’t holding their breath.

“The past few months and several weeks have shown us that we can’t really trust Dean Heller’s word,” said Ramirez of Save My Care. “So it’s nice that he’s saying these things but until he actually does, we’re going to continue to stay involved.”

Conservative blowback?

Heller’s vote against the repeal-only bill that he supported in 2015 is likely to anger conservatives. And it could embolden a primary challenger.

Juan Martinez, the Nevada director for the conservative group Americans for Prosperity, criticized Heller for his vote against clean repeal in a statement last week, imploring the senator to “get back on the right side of this issue.”

“Our activists will be watching,”  he said.

Moyle, the former Nevada GOP executive director, said a primary challenge already looks likely. 

Danny Tarkanian, a perennial candidate in the Silver State, is said to be considering a primary challenge. Tarkanian is also weighing another run for the 3rd District seat, which Democratic Rep. Jacky Rosen is vacating to challenge Heller for the Senate.

“I think the die was cast before [Friday’s] vote,” Moyle said. “I do think that the vote itself definitely affects the quality of the primary candidate.”

Heller’s vote for the skinny repeal bill could keep a more establishment GOP challenger from jumping in the race, Moyle said, and keep the White House and some GOP donors from backing a primary challenge.

Democrats keep pushing

As Heller faces pressure from the right, Democrats say they will also keep up the heat.

Citing Heller’s previous criticisms of the Senate GOP health care plan, Rosen called Heller’s vote for the skinny repeal bill “the biggest broken political promise in modern Nevada history.”

The Democratic Senatorial Campaign Committee is also continuing Pandora radio ads highlighting Heller’s past votes to repeal the 2010 health care law, according to a committee aide.

Democrats are expected to keep pushing the issue through ads, press conferences, and grass-roots protests.

“The Democrats on the ground out here are going to keep talking about this and what it meant for people,” the Nevada Democratic strategist said. “The health care issue has been dominating the political discussion since February.”

But one Nevada Republican operative suggested last week’s votes did not offer Democrats new fodder for attack ads against Heller, who has consistently voted to repeal the health care law.

Still, health care could continue to dog Heller, with an impending standoff over funding subsidies under the 2010 law to curb health care costs.

The Silver State is struggling because insurance companies are balking. Anthem recently announced that it was pulling out of the individual exchanges in 14 of Nevada’s 17 counties, leaving those counties without an insurer.

Health care could be a persistent campaign issue, but it may be too early to say for certain. With 15 months until Election Day, Heller does have time to explain his positions.

“I think it’s a no-win situation for him,” said Nevada GOP Rep. Mark Amodei. “So the good news is: this is happening in May, June and July, which gives him the opportunity to tell his story. The challenge will be: Do you do a good job of telling your story?”

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