Minutes before the U.S. Senate began a critical vote to advance Trumpcare , U.S. Senator Dean Heller (R) finally broke his silence on how he’d vote. So what did Heller vote for? And what does this mean for the future of health care in Nevada? Here’s the latest on where Heller stands and what happens next on Trumpcare.

Heller breaks the dam on the motion to proceed

After a month of keeping reporters and the public guessing, Senator Dean Heller finally announced his vote to allow Senate Republican leaders to proceed on Trumpcare.

What does this mean? The clearest answer is that this keeps alive the possibility of Republicans passing some version of Trumpcare. Heller joined 49 of his fellow Republicans in voting for the motion to proceed, which allowed Vice President Mike Pence to cast the tiebreaking vote in favor. Senator Catherine Cortez Masto (D) joined all other Democrats plus Senators Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska) in voting against.

What’s on the table now?

Senate Majority Leader Mitch McConnell (R-Kentucky) will likely emerge with a bill that has neither been scored by the Congressional Budget Office nor vetted in any committee that’s held public hearings.
The Senate bill may take the form of  a “skinny repeal” that merely repeals the insurance mandates that keep the health care exchanges functioning, or it may emerge with a bill to repeal major chunks of Obamacare, including Medicaid expansion and Planned Parenthood funding. Because McConnell has kept his plans under lock and key, Capitol Hill reporters have had to rely on speculation from lobbyists and other Congressional insiders to figure out what’s going on.

How Heller’s flip flopped

Just over a month ago, Senator Heller stood alongside Governor Brian Sandoval (R) in stating, “This bill […] Is not the answer. It is simply not the answer.” At that Las Vegas press conference, Heller announced his intent to vote against the motion to proceed.
Today, Heller voted for the motion, despite other Republicans stating they want to use this as an opportunity to lock in the very Medicaid cuts and rollbacks of consumer insurance protections Heller denounced as a “loss in coverage for millions of Americans” in June.
McConnell is now scrambling to get one of the Trumpcare bills passed in the coming days. With the original bill and the more severe Obamacare repeal bill still lacking the votes needed to pass, Senate Republicans may try to pass the “skinny repeal” bill in hopes of developing another bill during negotiations with the U.S. House (which passed its version of Trumpcare in May.)