In an emailed statement, spokesman David Bergstein writes:
"Senator Heller is awfully good at taking marching orders from Washington, which is why he trotted out before the cameras to say he’s leaving the door open to supporting the Republican health care plan. If he truly cared about protecting Nevadans from cost hikes, then why does he support ending the Medicaid expansion and why did he pledged to do everything he can to get to a yes on the Republican health plan? Voters already know they can't trust Senator Heller, and we’ll continue to make sure he’s held accountable for a plan that will force Nevadans to pay more for less care."
Heller has voted multiple times to repeal Obamacare and has said he's fine with the phase-out of Medicaid expansion. But now that hundreds of thousands of Nevadans' health care—and votes in 2018—are on the line, he has permission to take a "tough" stand. He's got the backing of Sandoval on that, and has tied himself tightly to the governor on this.
From this press conference, it seems pretty definite that Heller is going to be allowed to vote no, as leadership reportedly wants. He's their most vulnerable senator up in 2018, and they want to protect him. It does make McConnell's job of figuring out who the second senators he lets off the hook is. Remember, his majority is 52, and passing this will require 51—with Vice President Mike Pence on hand to provide that tie-breaking vote. So he can only let one more go. If Heller is off the hook, does McConnell appease the conservatives and make the bill harsher, or does Heller's opposition strengthen the spines of the senators from Medicaid expansion states?
It does shake up the calculus enough that it makes our opposition, our phone calls and emails, that much more important. If you have Republican senators, keep giving them hell.