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On Saturday afternoon, Mr. Trump posted on Twitter, venting about Mr. Heller and other Republicans who are not supporting the Senate bill.

On Friday, Mr. Sandoval acknowledged the obvious. Hes in the eye of the storm here, Mr. Sandoval said at a news conference in Nevada as Mr. Heller stood next to him, looking vaguely miserable as Mr. Sandoval announced his opposition to the Senate bill. The legislation could affect 210,000 Nevada residents insured through the health care laws expansion of Medicaid.

On Friday Mr. Heller said that he, too, was against the bill as it is currently drafted, leaving himself just enough wiggle room to continue his longstanding practice of being the senator in the middle, the man who wants to see the Medicaid program phased out, except when he decides he doesnt. (Mr. Heller has taken both positions publicly.) He has also voted to take away money from Planned Parenthood, but tells some select audiences that I have no problems with federal funding for Planned Parenthood.

Mr. Heller, whose spokeswoman said he was not available for an interview, said at the news conference Friday that this bill thats currently in front of the United States Senate is not the answer its simply not the answer. He said, Its going to be very difficult to get me to a yes.

As early as Thursday, the Senate will take a momentous vote to repeal the health law, and for Republicans from states that expanded their Medicaid program, the options are anything but palatable.

If the effort fails, the party risks being tarred as feckless: in control of the House, the Senate and the White House, but unable to come through with a promise that Republicans have been making from the day Mr. Obama signed the Affordable Care Act into law in 2010.

If the effort succeeds, expansion-state Republicans face the prospects of political hellfire: blame for every potential glitch in the health care system, from premium increases to canceled health plans and benefit losses.

The fact remains that Dean Heller owns his partys destructive health care repeal effort, William McCurdy II, chairman of the Nevada State Democratic Party, said in a prepared statement. He added, The damage to Dean Hellers flailing re-election campaign was already done long before this desperate press conference. Mr. Heller did not respond through his spokeswoman.

Mr. Heller, 57, represents the sort of state, both rural and working class, that has much to lose from the repeal of the Affordable Care Act. Nevada was once a national leader in the number of uninsured, but now the program has insured tens of thousands of its residents.

The state, like many around the country, has suffered a prescription drug crisis, and has among the highest rates of prescription painkillers sold and drug overdose deaths per capita. It also has a growing population of residents over the age of 55, a group particularly hammered by the Senate bill. All this has led Mr. Sandoval to take an unusually aggressive position for a Republican governor to preserve the current law.

Other Republican senators like Mr. Heller notably Susan Collins of Maine, Lisa Murkowski and Dan Sullivan of Alaska, Shelley Moore Capito of West Virginia and Rob Portman of Ohio come from states with similar populations and problems and have expressed skepticism about aspects of the bill.

Further complicating the matter are the four conservative Republicans Rand Paul of Kentucky, Ted Cruz of Texas, Mike Lee of Utah and Ron Johnson of Wisconsin who have already declared that they cannot support the health bill without changes to make it even more frugal. That put Senate leaders on notice that any move to placate the Dean Hellers of the Senate might only alienate other lawmakers still further.

Mr. McConnell continues to project confidence, even as the enthusiasm for the bill is largely muted. Im pleased that we were able to arrive at a draft that incorporates input from so many different members who represent so many different constituents who are facing so many different challenges, Mr. McConnell said last week. He added: There will be ample time to analyze, discuss and provide thoughts before legislation comes to the floor. And I hope every senator takes that opportunity.

In fact, on the day last week that the bill was rolled out, Mr. Heller posted on Twitter a photo of himself sitting in an ornate chair plowing through it, a considerable feat of reading given the arcana of the bills statutory language. But in spite of his earnest decoding of phrases like the applicable median cost benchmark plan, what Nevadans have to say will probably have more impact especially Mr. Sandoval, the most popular public official in the state, to whom Mr. Heller owes much.

The governor appointed Mr. Heller to the Senate seat in 2011 after the resignation of fellow Republican John Ensign and supported him during his successful run for a full term in 2012.

Here is one thing that people dont talk about a lot with Heller: He doesnt like the job, said Jon Ralston, editor of the Nevada Independent, a nonprofit news organization. He was planning to run for governor.

But Adam Paul Laxalt, the current Nevada attorney general, the grandson of former Senator Paul Laxalt of Nevada and the son of former Senator Pete Domenici of New Mexico is widely expected to run and has more or less pushed Mr. Heller out of the way.

Mr. Heller has never been the sort of rainmaker for the state that Senator Harry Reid of Nevada, the Senate minority leader from 2015 until early this year, was. Nor has he been a legislative leader. The bottom line with Nevadans historically had been if you took care of the home issues, then how you voted in D.C. on the other stuff was less important, said Michael Green, an associate professor of history at the University of Nevada, Las Vegas.

Mr. Heller appears to be running for re-election on a dogged effort to prevent the Trump administration from restarting licensing activities at the Yucca Mountain nuclear waste dump outside of Las Vegas. Beyond that, he has few other issues to lean on, and is stuck swatting away at critics from the left and the right as he struggles to define himself on health care, come what may.

Now he in this position of his own making, Mr. Ralston said, pressed by Trump people on one side, so he has a base problem, while the other side is running the most relentless digital protest campaign on any piece of legislation I have ever seen in this state.

The threat on Mr. Hellers right flank is real, as shown by former Representative Joe Heck, who during his race for a Senate seat in Nevada last year openly opposed Mr. Trump. Conservative voters stayed home and Mr. Heck lost to a Democrat.

Democrats have already recruited a Nevada freshman, Representative Jacky Rosen, to take Mr. Heller on. Representative Dina Titus is also looking at a possible run. This is probably going to be the last decision I make in my political career, Ms. Titus said. I want it to be the right one.

In the meantime, Mr. Heller has a long week in Washington awaiting.

A version of this article appears in print on June 25, 2017, on Page A1 of the New York edition with the headline: G.O.P. Senator With No Place To Take Cover.

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Health Law Repeal Leaves Nevada Republican Torn Between Lawmakers - New York Times

No one seems to like the Senate health care bill. Liberal wonks detest it. At least four Republican senators claim they arent prepared to support it, while other colleagues grumble about it. The White House, whose chief executive promised he wouldnt cut Medicaid, as this bill does, is balking.

But the Senate bill is very similar to the bill passed last month by the House. And the reason for that similarity is pretty basic: Both bills accomplish what Republicans want.

Despite the periodic dramas of reactionary versus conservative factions, Republicans are united around a couple of key goals. Both versions of the Republican health care legislation accomplish those goals, albeit in slightly different ways along slightly different timelines. Thats why, all the wailing aside, Congress will probably put a bill on President Donald Trumps desk that grievously damages Obamacare, if not precisely repealing it.

Both Senate and House versions will transfer hundreds of millions of dollars from poor and middle-class people, in the form of health care, to rich people in the form of tax cuts.

The wealthiest Americans, who have a disproportionate role in managing the economy, have famously awarded themselves a gargantuan share of its gains in recent decades. But Republicans continue to insist that gargantuan is less than sufficient. According to the liberal (and reliable) Center on Budget and Policy Priorities, the House health care bill would provide the 400 highest-income families in the U.S. with tax cuts worth about $7 million annually.

Thus health care legislation is a vehicle to achieve a preeminent goal of the Republican Party transferring more wealth to the wealthy. In addition, by changing the baseline for federal revenues, the legislation will facilitate another round of tax cuts later this year.

Another paramount goal is destroying Barack Obamas presidency. Since Republicans were unable to accomplish that in real time, they hope to do it retroactively. The Republican legislation keeps much of the architecture of Obamacare. But by cashing in its funding base, Republicans can seriously damage it.

The third goal the Republican legislation accomplishes is the rollback of an entitlement and a reversal of the trend toward universal health care.

Government support Medicare, Social Security, Medicaid tends to go on and on. Historical Republican opposition to all three of those programs long precedes their obsession with high-end tax cuts. If Obamacare laid the track for universal health care, Trumpcare promises to blow up the railroad bridge and send the whole enterprise plunging into a ravine, albeit in slow motion.

The Republican senators currently expressing their displeasure with the plan could easily thwart it. But will they? Majority Leader Mitch McConnell knows his troops. He knows what they want and, more important, what they will settle for. Opioid treatment funding, maybe, for Sens. Rob Portman of Ohio and Shelley Moore Capito of West Virginia, whose states have serious addiction problems. Perhaps a more aggressive retreat from Obamacare regulations for Sen. Mike Lee of Utah.

The chorus of boos heightens the political drama but it doesnt stop the play. Concessions are made. Victories are claimed. The legislation moves toward conclusion.

How many Republicans will really abandon the twin pillars that have upheld the GOP for nearly a decade tax cuts for the rich and the repudiation of Obama? How many will walk away from the cause of multiple generations of Republicans rolling back the welfare state?

Im betting fewer than three.

Francis Wilkinson is a columnist for Bloomberg View.

Published June 24, 2017, midnight in: Barack Obama, Donald Trump, entitlements, medicaid, Obamacare, Sen. Mitch McConnell, trumpcare, welfare

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Wilkinson: Republicans will pass Trumpcare - The Spokesman-Review

Vice President Mike Pence stopped in Chicago on Saturday, rallying top Republican officials to support the party's health care plan amid deep concerns among some rank-and-file senators over a plan poised for a vote soon.

"This is our moment. Now is the time. Every moment Obamacare survives is another day America suffers," Pence posted on his personal Twitter account about his remarks to a gathering of the Republican National Committee at a downtown hotel.

"Before summer's out, we'll repeal/replace Obamacare w(ith)/system based on personal responsibility, free market competition & state-based reform," the former Indiana governor tweeted. His posts often accompanied by photos of his appearance in a hotel ballroom.

Pence added, "That's the Republican way. That's the American way. And that's the way we're going to reform health care in the 21st Century."

Pence's visit comes as Senate Republicans review a new health care plan and weigh the political benefits and liabilities of moving forward. The proposal differs in some aspects from a House measure approved earlier this year. It includes provisions that would affect those lower-income or disabled individuals who gained health coverage through an expansion of Medicaid under the Affordable Care Act, as well as premium spikes for older Americans not yet eligible for Medicare.

John J. Kim / Chicago Tribune

The issue is acute for many states that expanded healthcare eligibility under the joint federal-state Medicaid program. The Senate GOP plan would give states three years to adjust to a sizable loss of federal reimbursement for Medicaid expansion.

But some GOP senators representing states that rapidly expanded Medicaid health care coverage have said the time frame is too short to adjust budgets. Currently, the federal government pays 95 percent of the costs of the expanded enrollment. At least five Republican senators have said they can't vote for the latest version in its present form. Senate Republican leader Mitch McConnell can't lose more than two and still pass the plan.

In Illinois, about 650,000 residents could lose Medicaid coverage under the Senate bill, and subsequent effects of state law, in 2021.

Some Republican governors who agreed to the Medicaid expansion have voiced concerns to the Senate and President Donald Trump's administration, such as Ohio Gov. John Kasich. In Illinois, which is undergoing a deep budget crisis, Gov. Bruce Rauner's administration has only said it has "concerns" as it reviews the plan, a response eliciting scorn from Democrats including prospective challengers next year.

The vice president also noted recent special election congressional victories by Republican candidates, including last week's victory by Karen Handel in suburban Atlanta over a strong challenge mounted by Democrat John Ossoff.

"I've got Georgia on my mind & it's driving nat'l media crazy," Pence tweeted. In a follow up post, he added, "The President promised we'd get tired of winning & a lot of people in the media are getting tired, but they better get used to it."

Pence left Chicago on Air Force Two in the afternoon to join Trump at the wedding of Treasury Secretary Steven Mnuchin. Illinois State Police said his motorcade may have caused a temporary traffic holdup but that the roads were clear as of 2:30 p.m.

Chicago Tribune's Marwa Eltagouri contributed.

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Pence stops in Chicago to meet with top Republicans - Chicago Tribune

The latest push to extend New Yorks short statute of limitations on child sex-abuse cases fizzled in Albany at the hands of Senate Republicans last week, when Senate Majority Leader John Flanagan refused to let the Senate vote on a bill that the Assembly overwhelmingly approved and that Gov. Andrew Cuomo supported.

State lawmakers ended their 2017 session on Wednesday with no Senate vote on the Child Victims Act or any alternatives that had been proposed, including one that the New York State Catholic Conference supported. The conference had opposed the bill the Assembly passed, arguing it would open the Catholic Church to lawsuits for abuse claims from decades ago, but it endorsed another pending bill that would have removed entirely the statute of limitations on prosecution.

None of the four Republicans senators representing Orange, Ulster and Sullivan counties would state their positions on the Child Victims Act when asked last week. James Seward and George Amedore, each of whom represents parts of Ulster County, didnt respond at all to the Times Herald-Records question. Spokesmen for John Bonacic and Bill Larkin each emailed statements that took no stance on the bill.

Advocates have pushed for 11 years to extend or eliminate the states statute of limitations on criminal charges and lawsuits involving sexual abuse of children. Under current law, the victims of such acts must seek criminal charges or sue before they turn 23 much too early, advocates say, for many traumatized abuse survivors to come forward. The bill that the Assembly passed would give victims until age 28 to seek prosecution and until age 50 to sue culpable institutions. It also would have given previously time-barred victims one year to bring cases.

Larkins spokesman said last week that Larkin was reviewing the reform proposals and hoped for an agreement before the session ended.

The senator is committed to working with his colleagues to protect children from sexual predators and hold abusers accountable and would like to see the State Legislature reach an agreement on this issue prior to the end of this years legislative session, spokesman Brian Maher said. He didnt respond when asked if Larkin would vote for or against the bill that the Assembly approved in a 139-7 vote on June 7.

Cuomo declared his support for the bill after the Assembly approved it. Advocates and Democrats had implored the Senates Republican leaders to bring the legislation to the floor before the session ended. The Times Herald-Record reported on the bills uncertain status and on a Saugerties man involved with the reform effort on Monday.

Bonacics spokesman, Conor Gillis, sent the Times Herald-Record a statement that touted past legislation but took no position on the Child Victims Act. He said only that Bonacic would review the bill if it came to the floor.

The statement read: The Senate has consistently passed legislation to protect New Yorkers from sexual predators, going as far back as 2006 when the Senate passed Megans Law, legislation ensuring that sexual predators register with the State and provide parents and members of the community with this information. The Senate has passed legislation to toughen criminal penalties on sexual predators, while also passing legislation restricting where sex offenders can go, explicitly barring them from entering school grounds. With that being said, should any version of the Child Victims Act come to the floor, Senator Bonacic will carefully review the details before he votes.

Chris McKenna

Lawmakers replenish campaign cash in Albany

After the conclusion of the 2017 legislative session in Albany on Wednesday, the New York Public Interest Research Group distributed its latest list of campaign fundraisers that state lawmakers held this year in the capital while debating funding and legislation their donors are so keenly interested in.

Here are the events that senators and Assembly members representing Orange, Ulster and Sullivan counties held and the minimum donation to get in the door (some had more than one):

Sen. John Bonacic, R-Mount Hope: $750, Fort Orange Club, Feb. 13

Sen. Bill Larkin, R-Cornwall-on-Hudson: $500, Fort Orange Club, Feb. 13 and June 14

Sen. George Amedore, R-Rotterdam, $500, The University Club, Feb. 28; $250, Angelos 677 Prime, June 7

Sen. James Seward, R-Milford, $800, Fort Orange Club, March 13; $250, The Albany Room, June 13

Assemblyman Karl Brabenec, R-Deerpark, $250, Pinto & Hobbs Tavern, March 20

Assemblyman Kevin Cahill, D-Kingston, $500, Renaissance Hotel, March 21

Assemblywoman Aileen Gunther, D-Forestburgh, $300, The Albany Room, March 28

Assemblyman James Skoufis, D-Woodbury, $250, City Beer Hall, June 14

Chris McKenna

Mass. congressman endorses Ryan in NY-19

Patrick Ryan, one of eight Democrats whove decided to run for Congress against Republican Rep. John Faso in 2018, has racked up his second endorsement despite the congressional race not being until November next year.

Rep. Seth Moulton of Massachusetts announced the endorsement of Ryan and seven other Democratic veterans on Wednesday, saying that the Democratic Party needs a new generation of leadership, and that its time to stop rehashing 2016 and deliver a vision for America that addresses the real challenges facing Americans in all parts of our country.

Ryan, 35, of Brooklyn, grew up in Kingston. Hes a graduate of Kingston High School and the United States Military Academy at West Point. He went on to serve two combat tours in Iraq, rising to the rank of captain. He began two start-up technology businesses and currently works for Dataminr, a New York City start-up company that analyzes data from social media.

Ryan and Moulton, whos in his second term, already shared a connection. Ryan said he began considering a run for Congress through a network of military veterans that included Moulton, a Marine Corps veteran and Democrat who represents Massachusetts sixth congressional district.

Both Moulton and Ryan were also recruited to run for Congress through the Boston-based group New Politics, which works to recruit those with public service backgrounds to run for office.

James Nani

Legislature OKs ward system for school boards

State lawmakers passed a bill last week that would enable school districts to create wards for the election of school board members, an idea that supporters in the Pine Bush School District and in Sullivan County have promoted since 2015 as a way to limit the ability of voting blocs to control boards.

The bill, approved in the last week of the 2017 legislative session, was sponsored by Assemblywoman Aileen Gunther, D-Forestburgh, and Sen. Bill Larkin, R-Cornwall-on-Hudson. It glided through the Assembly in a 140-2 vote on Monday and cleared the Senate in a 62-1 vote the next day.

Adopting a ward system would require a referendum. If approved by voters, a district could be divided into three to nine wards.

The legislation mistakenly required elections for all board seats in the same year. The sponsors, who say they meant to have staggered elections, plan to introduce an amendment to retroactively change the wording. The bill must be sent to Gov. Andrew Cuomo to sign or veto.

Amanda Spadaro and Chris McKenna

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The Fray: Senate Republicans snub child sex-abuse bill as session ends - Times Herald-Record

By Mallory E. SoRelle and Alexis N. Walker By Mallory E. SoRelle and Alexis N. Walker June 23

After President Trump declared his intention to leave the Paris climate agreement, three Democratic state governors announced that their states would continue to pursue efforts to reduce greenhouse gas emissions. Meanwhile, Republicans in Congress vowed to enact federal laws to preempt state and local immigration policies at odds with the GOP agenda. This contradicts conventional wisdom, which holds that Republicans promote states rights while Democrats want more policymaking power concentrated at the federal level.

[This explains why there are so few Republican women in Congress]

Is this apartisan reversal on states rights? Our research suggests not. Rather, both parties have historically promoted or preempted states rights depending on their partys political goals for a given issue.

Both Democrats and Republicans care about states rights

The United States has a federal system, which means that state and federal governments divide and share power to make and enforce laws. As the chartbelow shows, the federal government has a long history of enacting laws that preempt, or limit, states and localities policymaking powers.

But federal preemption jumped sharply in the 1970s and again over the past decade. About 6 percent of federal laws enacted between 2000 and 2009 preempt state and local powers, compared with about 3.5 percent during the previous decade.

Federal preemptions by decade

How we did our research

To learn more about how the parties at the national level approach states rights, we surveyed every federal law enacted between 1990 and 2012 that preempted state power in some way. As the figure below shows, we found that both parties have contributed relatively equally to the dramatic increase in federal preemption.

Preemption statutes enacted, by party control of House and presidency, 1990-2012

Over about the past 20 years, Republicans in Congress and in the White House have been just as willing to limit state power as have Democrats. For example, Presidents Bill Clinton and George W. Bush each signed 64 preemption statutes into law during their respective eight years in office. Similarly, between 1990 and 2012, no matter which party controlled the House of Representatives, roughly the same average number of preemption policies became law each year.

Parties preempt states rights in different ways

However, exactly how they limit state authority varies, in keeping with the parties different political goals.

The parties enact different types of preemptions. Republicans are more likely to impose what are known as ceiling preemptions. These laws cap the amount of regulation states can enact on a particular issue. For example, a ceiling preemption might prohibit states from setting new or more stringent emissions standards for a particular industry.

Democrats, by contrast, are much more likely to limit state power by setting floor preemptions, or minimum standards that states must meet but can exceed if they want to. For example, such a law might set a federal emission standard for a particular industry but allow states to enact tougher emissions standards.

[Yes, Mitch McConnells secretive lawmaking really is unusual in these 4 ways]

As shown in the chartsbelow, we find that when Democrats controlled the House between 1990 and 2012, 57 percent of preemption laws enacted were floors. By contrast, when Republicans controlled the House, 33 percent of laws enacted with preemption statutes were floors; the remaining 67 percent were ceilings limiting state regulatory power.

Floor vs. ceiling preemptions as enacted by party control of House, 1990-2012

You can see this illustrated in the partisan gap between floor and ceiling preemptions in public health and consumer safety. When Democrats controlled the House, 75 percent of preemptions were floors, compared with36 percent of those passed under Republican majorities. That means that Democrats in Congress used preemptions to create a base level of health and safety regulation across the states while Republicans did so to limit state authority to regulate in this area.

For example, the Card Act of 2009, enactedunder Democratic control, created new credit card rules to protect consumers but left states able to add still more regulations. By contrast, a Republican-led 2001 amendment to the Consumer Product Safety Act introduced federal regulations for electric bicycles that explicitly overrode more stringent state laws.

States rights in the Trump era

States responses to Trump and the current Republican agenda are entirely consistent with these patterns, as the parties stands on states rights vary with the issue at hand.

For instance, the Trump administration is trying to remove tough environmental regulations and state and national Democratic leaders are resisting by turning to state power. Just a few years ago, when Democrats controlled the House, Democratic Party leaders in Congress passed federal bills that forced states to set minimum environmental protection standards, for example, by regulating the use of lead pipes that carry drinking water.

But in the ongoing debate over the federal Medicaid program that funds health care forlow-income and disabled people, the tables are turned. Many Republicans want to shift toward block grants, which would let each state decide how to run and fund its Medicaid program. Predictably, Democrats are opposed; they want enough federal control to ensure that current benefits are protected.

The sides flip once more on immigration. Congressional Republicans want to preempt state power to prevent Democratic cities from becoming sanctuary cities. Meanwhile, congressional Democrats are fighting to protect state and local rights to resist Trump administration policies against sanctuary cities.

[Bartels: The wave of right-wing populist sentiment is a myth]

In sum, neither party holds a principled position on whether to preempt or protect states rights. Instead, both parties use federal power to limit state authority or to promote it depending on their partys policy goals. Expect to see such strategic partisan use of federalism continue as the parties go to battle over Trumps and the GOPs agenda.

Mallory E. SoRelle is an assistant professor of government and law at Lafayette College, specializing in the study of American politics and public policy. Follow her on Twitter @SoRelleM.

Alexis N. Walker is an assistant professor of political science at Saint Martins University, with a focus on American politics and organized labor.

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Both Democrats and Republicans care about 'states' rights' when it suits them - Washington Post