美国国家公共电台 NPR Nevada Voters, Divided Over Health Care, Put Moderate Republican In Tough Spot

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 1 for years to repeal 2 and replace the Affordable 3 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 4, high-energy, controversial show of your life. Please buckle 5 up.

ARI SHAPIRO, BYLINE 6: 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 7, Newt Gingrich, Ronald Reagan and other conservative heroes.

WAYNE ALLYN ROOT: Some of them are older, and some of them are newer - Ted 8 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 9 to kill this bill.

ROOT: They're very angry. They're irate 10. They're enraged 11, 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 12 inspired by the TV show "The Handmaid's Tale," which is about the subjugation 13 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 14 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 15 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 16 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 17. 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 18. 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 19 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 20 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 21. If you look behind us, you can see the trophies 22 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 23 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 24 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")