The individual mandate encourages healthy people to buy insurance, decreasing the average health care costs of all the insured people - and therefore, their premiums. Do not believe any prattle about Mitch McConnell "being OK with a loss".
A no vote by Heller would not seal the fate of the bill, however.
Nonetheless, Heller's announcement underscores the scant margin of error Republican leaders must deal with. And Republicans have a narrower margin in the Senate, needing at least 50 of the 52 GOP members to pass their bill.
The Senate measure resembles legislation the House approved last month that the nonpartisan Congressional Budget Office said would mean 23 million additional uninsured people within a decade and that recent polling shows is viewed favorably by only around 1 in 4 Americans.
The cutbacks the Senate bill, which would end Medicaid expansion, would cost the state $120 million a year by 2022, with the cost rising sharply after that the governor said.
Immediately after its release four Republican senators said they couldn't support it. Let's hope there are more who care enough about the health of women, children and the elderly to stop this travesty. It would allow insurers to cover fewer benefits and repeal tax boosts on wealthier people that help finance the statute's expanded coverage. The legislation would phase out federal funding for Medicaid expansion - now covering about 11 million people in 31 states - beginning in 2020, and shift more of those costs back to states. If federal Medicaid funding is restricted, costs in billions would shift to Albany, requiring New York State to choose between raising taxes, drastically reducing services, shifting costs to New York City or kicking entire groups of people off the program.
Trump's comments come amid the public opposition of five Republican senators so far to the Senate GOP plan that would scuttle much of former President Barack Obama's health law.
"We can not support the current bill", said Senator Rand Paul, R-KY. He added that Nevada "is one of the most improved states in the country" in expanding coverage. Heller's seat is up for reelection next year, and a Democrat won Nevada's other Senate seat by a 2.4 percent margin in 2016. Some conservatives think current plans don't go far enough; others say those plans will hurt numerous people they represent.
However Obama, whose best-known domestic policy achievement stands to crumble, offered a scathing critique of the new bill just hours after its release.
"Threading that needle is going to be very, extremely hard", she said. Senator Ron Johnson, Republican of Wisconsin, said Sunday that "there's no way we should be voting" on the legislation this week. It will be measured in lives, mostly of the poor and people of color.
He added that "small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, can not change the fundamental meanness at the core of this legislation".
Heller said he can't support a bill "that takes insurance away from tens of millions of Americans and hundreds of thousands of Nevadans".
"There are lots of frustrated senators saying they didn't like the process of writing this bill, [but] none of them saying they would use their power to do anything about it", says Zwillich.
"It isn't any one factor but it's all of those factors put together that will influence my decision", Sen.