Someone’s worried about his next election.

Sen. Dean Heller (R-NV) CREDIT: AP Photo/Harry Hamburg

Sen. Dean Heller (R-NV) is probably the most endangered Republican up for reelection in 2018. As of Friday afternoon, he now appears likely to vote against the Republican plan to phase out Medicaid and dismantle much of the Affordable Care Act.

“It’s going to be very difficult to get me to a yes,” Heller said at a press conference in Las Vegas. “They have lots of work to do.”

Heller expressed particular concerns about the bill’s impact on Medicaid, and especially on states, such as Nevada, that expanded Medicaid under Obamacare. “You have to protect Medicaid expansion states,” the senator said.

Heller also warned that Trumpcare would strip coverage from “millions of Americans.”

Last month, a version of Trumpcare that would strip health care from 23 million people passed the House. The Senate then took the House bill and, in a rushed, closed-door process, made it harsher. Among other things, it effectively phases out the Medicaid program in it entirety by imposing a cap on Medicaid spending and then reducing the real value of that cap each year.

Seventy-five million individuals rely on Medicaid for health coverage, and the program primarily serves vulnerable populations such as the poor, the disabled, and the elderly.

It is highly unlikely that any of the 48 members of the Senate Democratic Caucus will support this bill, which means that Senate Majority Leader Mitch McConnell (R-KY) can only afford to lose two Republicans or the bill will fail.

Nevertheless, it is possible that McConnell gave Heller a pass to oppose the unpopular health plan to preserve Heller’s ability to get reelected. It is also possible that Heller, like Rep. Fred Upton (R-MI) in the House, will agree to support the bill if McConnell agrees to minor or even cosmetic changes. So Heller’s opposition to the Medicaid phase-out should be taken with a grain of salt.

Nevertheless, for the time being, Heller appears to be a Republican “no” vote on Trumpcare.