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Nevada Gov. Sandoval still doesn’t support Senate health bill. That’s big trouble for Republicans.

First Published      Last Updated Jul 15 2017 10:33 pm

Home-state U.S. Sen. Dean Heller probably won’t, either, and that could mean McConnell loses a third Republican vote — and perhaps the GOP plan.

Providence, R.I. • Brian Sandoval spent his Saturday morning 3,000 miles from home tucked away in a convention center ballroom where two top Trump administration officials tried to persuade him that everything would be okay under their plan to dramatically alter the nation's health care system.

They couldn't.

As a result, the Republican Party's seven-year quest to overhaul the Affordable Care Act remains at serious risk of hitting another wall next week.

More than any other Republican in the country right now, Sandoval, the centrist governor of Nevada, could hold the power to sink or salvage the health care bill Senate GOP leaders are hoping to pass in the coming days.

Sandoval's voice is more influential than perhaps any other Republican governor here — largely because what he decides is widely expected to determine the vote of his home-state colleague, Sen. Dean Heller. Senate Majority Leader Mitch McConnell, R-Ky., has already lost two Republican votes. A third would be game over.

Among the 32 state executives who attended the National Governors Association summer meeting here this weekend, no one drew more attention and interest than Sandoval, a square-jawed, 53-year-old with neatly parted dark hair, a made-for-TV smile and a political disposition that is the antithesis of President Donald Trump.

All weekend, he has been besieged — by reporters taking his temperature and by administration officials, including Vice President Mike Pence, trying to persuade him that the Senate bill would not hurt his Nevada constituents despite its deep federal spending cuts to Medicaid.

So far, he isn't buying what the administration is selling. "I'm no different than I was," Sandoval told reporters after a governors-only meeting Saturday morning with Health and Human Services Secretary Tom Price and Seema Verma, administrator of the Center for Medicare and Medicaid Services. He said he is likely to come to a final decision "early next week."

The Trump administration mounted a full-court effort here in Providence, recognizing the resistance not only by Sandoval but other Republican governors who are potentially influential with their state's senators. Despite a heavy public and private effort, however, the administration appeared to have changed no minds — and may even have hardened some of the opposition.

One moment in particular drew private criticism from governors of both parties — when Pence openly targeted Ohio Gov. John Kasich, a Republican who is a vociferous opponent of the GOP health care proposal, with inaccurate facts about Medicaid waiting lists for the disabled in Ohio.

At a meeting Saturday morning with governors, Price and Verma sought to discredit other analyses showing potentially devastating consequences for states under the Senate bill, including a yet-to-be released analysis by the nonpartisan Congressional Budget Office and an independent analysis by the health care firm Avalere, which was presented at the meeting.

Other key Republican governors also expressed skepticism about the bill after the closed-door gathering, highlighting the Trump administration's struggles. "There's still work to be done," said Arizona Gov. Doug Ducey. Arkansas Gov. Asa Hutchinson theorized that the Senate bill "is probably not the bill that's actually going to be voted on."

Heller cited Sandoval when he announced his opposition to an earlier version of the Senate bill. The two men and their staffs are in close contact analyzing the newer version.

Sandoval, first elected in 2010, was the first Republican governor in the nation to decide to expand Medicaid under the Affordable Care Act. He sees some strong similarities between his current predicament and that one.

"We did a tremendous amount of due diligence leading up to that decision," he said. "This is the identical process that I used leading up to making that decision."

Sandoval well recognizes the position he holds in the freighted debate over the future of Obamacare — and with it perhaps the future of the Republican Party. "Of course I am," he replied when a reporter asked him if he is feeling the weight of his position. "That's part of what being a governor is all about."

"A lot of people's lives and health and health care and quality of life is in the balance," he added. "I'm a former judge. I take in all the information and then I make a decision and that's what I'm doing now."

The Senate Republican proposal would cut $772 billion from Medicaid over the next decade and result in 22 million fewer Americans with insurance compared to current law, according to a CBO assessment of an earlier version. An updated score is expected Monday.

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