WIUM Tristates Public Radio

Nevada Voters, Divided Over Health Care, Put Moderate Republican In Tough Spot

Jul 7, 2017
Originally published on July 7, 2017 7:18 pm

When senators come back to Washington on Monday, a handful of Republicans will help decide the fate of legislation that could reshape health care in America.

One of them is Nevada Republican Dean Heller.

Sen. Heller is one of a small bunch of Republicans who have said they will not support the latest draft proposal to repeal and replace the Affordable Care Act, or Obamacare. Republican leadership can only lose the support of two of its own senators and still pass such a bill.

The Republican senators who say they'll vote no on the latest health care plan fall into two camps. Members of the party's right wing think this proposal is too timid and doesn't go far enough to undo the Affordable Care Act. More moderate Republicans, like Heller, think it is harsh and goes too far.

"I'm telling you right now, I cannot support a piece of legislation that takes away insurance away from tens of millions of Americans and hundreds of thousands of Nevadans," he said.

Nevada's popular governor, Brian Sandoval, was the first Republican governor in the country to expand Medicaid under the Affordable Care Act. More than 200,000 uninsured people got coverage after the expansion.

With that expansion of coverage, many people here are watching the fate of this bill to learn whether they'll be able to keep going to the doctor.

Heller's position has prompted advocacy groups and constituents on both sides of the issue to flood his office with calls.

For weeks, protesters have been showing up outside the senator's Las Vegas office urging him to oppose any changes to the health care system that would roll back provisions like the Medicaid expansion or funding for Planned Parenthood.

Cyndy Hernandez, who helped organize the most recent protest, says Heller's opposition to the bill GOP leadership is crafting isn't necessarily a done deal — "not until he marks that button on his desk in the Senate chamber."

Patients at FirstMed clinic, where 80 percent of the patients are on Medicaid, voice their concern on a daily basis, nurse Maria Vital says. Administrators say the clinic would be forced to close without the funding it gets through the Affordable Care Act. Many of these patients went years without seeing a doctor for easily treatable conditions before the clinic opened, Vital says.

"They're very scared," she says. "They're asking us what will happen to them, and I tell them we will try to be here as long as we can for them."

Across town in Henderson, Taylor Lewis lives with her 7-year-old daughter Riley in a modest condo, with a couple of dogs and a large collection of plastic toy dinosaurs. Riley whispers their names as she pulls each one out of a big paper bag: stegosaurus, pterodactyl, Tyrannosaurus rex.

Ten days after Riley was born, a helicopter rushed her to the hospital for emergency heart surgery. When Taylor got over the shock of her daughter's near-death, she got another shock. The helivac bill totaled $20,000.

On top of being a single mom, Taylor has been working part time and studying part time — she just finished her master's in public health.

Until she finds a full-time job, she depends on Medicaid to cover all of her daughter's medical costs.

She sometimes thinks about what her life would be like if Nevada had not expanded Medicaid coverage.

"I mean, I'd be without anything. I'd be without a car, a house," Taylor says.

For people on both sides of this debate, the stakes seem far higher than a typical piece of legislation.

People like Taylor feel that what has been proposed puts their lives on the line; Republicans who support the bill see a chance for lawmakers like Heller to keep a promise that Republicans have made in every campaign for nearly a decade.

Conservative talk radio host Wayne Allyn Root says nearly every caller now talks about voting Heller out of office because of his opposition to the draft proposal that Republicans floated in recent weeks.

"If Heller votes no on the repeal he's got to go, you gotta primary him," he says.

Root broadcasts out of his home studio for three hours each day. He has piles of framed photographs, including images of him with President Trump, Newt Gingrich and Ronald Reagan.

Root says his listeners are aghast that a Republican senator from their own state could be responsible for helping to kill this bill.

National groups on both sides have put millions of dollars into TV ads trying to sway Heller. The senator is home for the July Fourth recess this week, but he isn't spending that time holding town halls.

In the small town of Ely, he rode a horse in the July Fourth parade. He watched the fireworks in Elko, another town in rural northern Nevada. Even there, some people heckled him.

Heller declined the Republican Party's invitation to march in the town of Pahrump, which has the same spectrum of Republican views that's dividing the Senate.

Local party chairman Joe Burdzinski thinks the bill is too timid. He'd stand with senators like Rand Paul and Ted Cruz, holding out for a full repeal.

"The Republican Party has said for the last eight years we're gonna repeal and get rid of Obamacare. That's what Donald Trump said he wanted to do, that's what other Republicans running for office have said. Now they have to live up to that commitment to the American people because ... the American people voted for that," he says.

Leo Blundo, another official with the Nye County Republican Central Committee, has more sympathy for Sen. Heller, but doesn't quite believe Republican leaders who say this is the only train leaving the station.

"It's public knowledge we got both houses [of Congress]," he says. "Get some business done. ... Quit mickey-mousing around and get some work done."

For Heller, the considerations about Medicaid expansion and repeal promises might all take a back seat to a more pressing reality. He's up for re-election next year — a Republican in a state that has gone blue for the last three presidential elections.

Whatever position he takes on the final bill, that race will be far from an easy win.

Copyright 2017 NPR. To see more, visit http://www.npr.org/.

ROBERT SIEGEL, HOST:

When senators come back to Washington on Monday, a handful of Republicans will decide the fate of a bill that could reshape health care in America. Republicans have been promising for years to repeal and replace the Affordable Care Act, or Obamacare. Senate leaders say this is their best chance to do it. And one of the holdouts is Nevada's Republican Senator Dean Heller. Our co-host Ari Shapiro went to Nevada to see what it feels like for a lawmaker at the center of the debate.

(SOUNDBITE OF RADIO SHOW, "WAR NOW: THE WAYNE ALLYN ROOT SHOW")

UNIDENTIFIED MAN: Warning - you're about to experience the most passionate, high-energy, controversial show of your life. Please buckle up.

ARI SHAPIRO, BYLINE: For three hours each day, the conservative talk radio host Wayne Allyn Root broadcasts out of his home studio just outside Las Vegas. He has piles of framed photographs here showing him with President Trump, Newt Gingrich, Ronald Reagan and other conservative heroes.

WAYNE ALLYN ROOT: Some of them are older, and some of them are newer - Ted Cruz, Rand Paul.

SHAPIRO: I ask him how many of the people who call into his show these days want to talk about health care, and he says all of them.

ROOT: Oh, every caller talks about voting Heller out. I don't think I have a caller who doesn't talk about - if Heller votes no on the repeal, he's got to go; you've got a primary him.

SHAPIRO: Meaning find a more conservative Republican to challenge Heller when he runs for re-election next year. Root says his listeners are aghast that a Republican senator from their own state could be responsible for helping to kill this bill.

ROOT: They're very angry. They're irate. They're enraged, and they have a rage towards Dean Heller because if someone elects Dean Heller who believes Obamacare's terrible - and I don't care what Dean Heller thinks - his responsibility is to fight for the people that elected him. He doesn't get it.

SHAPIRO: They aren't the only ones feeling enraged.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED CROWD: (Chanting) Heller, vote no. Heller, vote no. Heller, vote no.

SHAPIRO: At Heller's Las Vegas office, a couple dozen people stand in the parking lot, chanting Heller, vote no. They wear red cloaks and white hoods inspired by the TV show "The Handmaid's Tale," which is about the subjugation of women. Jean Green Dunbar acknowledges that it's an odd scene especially since it's more than a hundred degrees outside.

JEAN GREEN DUNBAR: We may look ridiculous, but we're not a bit more ridiculous than that health care bill. Say no.

SHAPIRO: I pull aside one of the organizers, Cyndi Hernandez.

He's a no vote. Shouldn't you be thanking him and congratulating him and celebrating him rather than protesting him?

CYNDI HERNANDEZ: We're just going to keep reminding him, no, no, no. This is terrible for Nevada. He's kind of flip-flopped before, and he's told people before different things. And we just want to keep reminding him, no.

SHAPIRO: The Republican senators who say they'll vote no on the health care bill fall into two camps. Members of the party's right wing think the original Senate proposal is too timid and doesn't go far enough to undo the Affordable Care Act. More moderate Republicans like Senator Heller think that version of the bill is harsh and goes too far. Last month Heller explained his opposition at a press conference.

(SOUNDBITE OF PRESS CONFERENCE)

DEAN HELLER: I'm telling you right now. I cannot support a piece of legislation that takes insurance away from tens of millions of Americans and hundreds of thousands of Nevadans.

SHAPIRO: Standing next to him was Nevada's popular Republican governor, Brian Sandoval. Sandoval is a crucial player here. He was the first Republican governor in the country to expand Medicaid under the Affordable Care Act. In Nevada, more than 200,000 uninsured people got coverage. Many of those people are watching the fate of this bill to learn whether they'll be able to keep going to their doctor. Maria Vital is a nurse at FirstMed clinic where 80 percent of the patients are on Medicaid.

MARIA VITAL: Patients actually do voice out that this time there are concerns about it. They're also very scared. Their asking us what will happen to them.

SHAPIRO: What do you tell them?

VITAL: And I tell them, we will try to be here as long as we can for them.

SHAPIRO: If this bill passes, she says the clinic may have to close.

(SOUNDBITE OF DOG BARKING)

TAYLOR LEWIS: Hey.

SHAPIRO: Hi.

LEWIS: That's my dog.

SHAPIRO: Hi, guys.

Taylor Lewis lives with her 7-year-old daughter, Riley, in a modest condo with a couple of dogs and a large collection of plastic toy dinosaurs. Riley wants to be a paleontologist when she grows up. She knows all the names.

RILEY LEWIS: A triceratop (ph), a stegosaurus.

SHAPIRO: Ten days after Riley was born, she turned blue. A helicopter rushed her to the hospital where she had emergency heart surgery. When Taylor got over the shock of her daughter's near death, she got another shock.

LEWIS: The first bill I actually received was for the helivac, and that was $20,000.

SHAPIRO: That was back when they lived in Delaware. Since they moved to Nevada a few years ago, Riley still has to go to a heart doctor every couple months.

LEWIS: She has a leak right now, so they're really keeping an eye on that.

SHAPIRO: On top of being a single mom, Taylor has been working part-time and studying part-time. She just finished her master's in public health. Until she finds a full-time job, she depends on Medicaid to cover all of her daughter's medical costs. She sometimes thinks about what her life would be like if Nevada had not expanded Medicaid coverage.

LEWIS: I mean I would be without anything. I would be without a car. I would be without a house. I don't know.

SHAPIRO: So on this afternoon, she's headed into downtown Las Vegas for a phone bank at a union hall.

LEWIS: (Laughter).

SHAPIRO: Have you ever done anything like this before?

LEWIS: No. I've been mostly just focusing on my thesis, so this is all new to me. Can you imagine if I - you know, something happened and I wasn't able to say, well, I tried?

SHAPIRO: At the hall, a bunch of volunteers sit around tables with laptops. They come from local unions, Planned Parenthood and other liberal groups.

UNIDENTIFIED WOMAN: Welcome back (laughter).

(APPLAUSE)

SHAPIRO: They're getting people to call Heller's office and urge him to vote no on the health care bill.

(CROSSTALK)

SHAPIRO: For people on both sides of this debate, the stakes seem far higher than a typical piece of legislation. National groups on both sides have put millions of dollars into TV ads trying to sway Heller. And while this cacophony rages, where is the senator?

(SOUNDBITE OF ARCHIVED RECORDING)

HELLER: Hi, everybody. It's Fourth of July. I'm here in Elko.

SHAPIRO: He posted this video on social media. He has not done a town hall or interviews this week. That includes with us. We tried. He's been hitting small towns in the northern part of the state. In Ely, he rode a horse in the July Fourth parade. Even there, some people heckled him. Heller declined the Republican Party's invitation to march in the town of Pahrump. Local Party Chairman Joe Burdzinski dressed as George Washington in Pahrump's parade.

JOE BURDZINSKI: Well, our float won. That's the eighth year in a row. We won the most patriotic. If you look behind us, you can see the trophies from the years past.

SHAPIRO: Burdzinski met us in the party headquarters, a hall decorated with ribbons and posters. One says Pahrump loves the Trump. To get to this town, you drive about an hour west of Las Vegas over a mountain range to the edge of Death Valley. And in this conservative community, you see the same spectrum of Republican views that is dividing the Senate. Burdzinski thinks the bill is too timid. He'd stand with senators like Rand Paul and Ted Cruz, holding out for a full repeal.

BURDZINSKI: The Republican Party has said for the last eight years, we're going to repeal and get rid of Obamacare. That's what Donald Trump said he wanted to do. That's what other Republicans running for office have said. Now they have to live to that commitment to the American people because that's - the American people voted for that.

SHAPIRO: Another Republican named Leo Blundo joins us, and he has more sympathy for Senator Heller. He agrees the Affordable Care Act isn't working. Fourteen of Nevada's 17 counties will have no insurance companies on the exchange next year. That would leave about 8,000 people without insurance options. But Blundo believes that if this bill fails, Republicans can come up with a better one. He rolls his eyes at Republican leaders who say that if this ship doesn't sail, they'll have to work with Democrats on the other party's terms.

LEO BLUNDO: It's public knowledge (laughter). We've got both houses. Get some business done, you know? Oh, we can't do this; I can't do that. Listen. Quit Mickey Mousing around. Get some work done, OK?

SHAPIRO: For Senator Heller, the considerations about Medicaid expansion and repeal promises might all take a back seat to a more pressing reality. He's up for re-election next year, a Republican in a state that has gone blue for the last three presidential elections. Whatever position he takes on the final bill, he's going to make a number of friends and a whole lot of enemies.

(SOUNDBITE OF MARC MOULIN'S "HUMPTY DUMPTY")

SIEGEL: That was our co-host Ari Shapiro reporting this week from Nevada.

(SOUNDBITE OF MARC MOULIN'S "HUMPTY DUMPTY") Transcript provided by NPR, Copyright NPR.