By Lisa Hagen - 03-09-17 06:00 AM EST
While different factions of the GOP wrangle over the details of the newly unveiled ObamaCare repeal-and-replace plan, vulnerable Republican lawmakers face another choice: whether to talk about it at all.
Republicans facing challenging reelection races in 2018 have so far been largely silent on the legislation, which has sparked backlash from Democrats and conservative Republicans alike.
Nevada's Dean Heller, the most vulnerable GOP senator up for reelection, has yet to comment on the House bill even as pressure mounts on him from both sides of the aisle.
Heller is the only senator facing reelection in a state that chose Hillary Clinton for president in November. Democrats have already set their eyes on him as a top target in a year when their own party will mostly be on defense, with 10 senators up for reelection in states President Trump won.
Following the release of the GOP healthcare legislation, the Democratic Senatorial Campaign Committee (DSCC) called on Republican Senate candidates to break their silence and condemn the proposal.
"If Republican Senate candidates refuse to denounce this plan, it will be just another demonstration that they're willing to push the agenda of the wealthy and well-connected at the expense of Americans who actually work for a living," said DSCC spokeswoman Lauren Passalacqua.
Four GOP senators, including Cory Gardner (Colo.), chairman of the National Republican Senatorial Committee (NRSC), have already vowed in a letter to vote against any bill that affects the Medicaid expansion created by ObamaCare. The House GOP plan stops new enrollments in the Medicaid expansion in 2020.
The Nevada Democratic Party blasted Heller for being absent from the letter, estimating that 370,000 Nevadans could lose health coverage under the GOP bill. Nevada is one of 32 states, including Washington, D.C., that expanded Medicaid.
But Heller is also feeling the heat from within his own party from activists who want to see ObamaCare repealed.
One Nation, an advocacy group aligned with Senate Majority Leader Mitch McConnell (R-Ky.), has launched radio ads targeting the Nevada Republican. The group's targets also include vulnerable Senate Democrats and other Republicans whose support could waver. The ads, which are part of a $3 million campaign, started running the same day that the House GOP unveiled the bill.
"My sense is [Heller] will be quiet as long as possible, but at the end of the day he is going to have to move to the middle because that's where his greater challenge is," said a Western GOP political consultant.
Arizona Sen. Jeff Flake is another vulnerable GOP incumbent who declined to take a stance until looking at the bill more. His state also expanded Medicaid, but Trump won Arizona by more than 3 points.
"Negotiations are tough enough without commenting before I understand it all," Flake told CNN. "We've got a small margin. You know the numbers. It's tough."
Flake has better prospects in his general election than Heller does, but the Arizonan faces more of an uphill battle in his primary. He has at least one primary challenger, former state Sen. Kelli Ward. State Treasurer Jeff DeWit, the former COO of Trump's presidential campaign, is another potential contender.
McConnell said the Senate will take up the House GOP's plan, but as it currently stands, there are enough Republican senators on the fence to sink the measure.
The House GOP plan, titled the American Health Care Act, proposes rolling back subsidies, taxes and the mandate requiring people to buy health insurance. The plan also overhauls Medicaid expansion by capping federal payments and blocks federal funding for Planned Parenthood.
The bill would replace the subsidies with tax credits. And, as a replacement for the controversial individual mandate, it would allow insurers to raise premiums up to 30 percent for individuals who have a gap in coverage of at least two months.
GOP Sens. Rand Paul (Ky.), Mike Lee (Utah) and Ted Cruz (Texas) have all critiqued the bill from the right. And Sen. Lisa Murkowski (R-Alaska) has said she won't vote for a bill that includes defunding Planned Parenthood.
Before it gets to the Senate, the bill must first clear the House, where it has also met resistance. The proposal has earned fierce rebuke from conservatives - primarily the House Freedom Caucus - who characterize it as a watered-down version of the existing healthcare law, dubbing it "ObamaCare lite."
Unusually, House Freedom Caucus opposition could end up helping more moderate Republicans like Heller if its members block the legislation in the House.
"Best-case scenario for someone like Heller is that [the House bill] simply doesn't get to him," the Western GOP political consultant noted.
Despite the vocal criticism, Trump has still backed the bill. Speaker Paul Ryan (R-Wis.) believes that he will have the votes needed to pass it on the House floor.
Meanwhile, several House GOP members who will likely face competitive reelection races are starting to react to the bill. So far, none has completely broken ranks with the party.
Rep. Mike Coffman (R-Colo.) came out early in support of the GOP's plan. Coffman is a top Democratic target and represents a district Clinton won by nearly 9 points.
GOP Reps. Peter Roskam (Ill.) and Kevin Yoder (Kan.) also back the bill. While their districts have been reliably red in House elections, voters in both chose Clinton for president. Rep. Bruce Poliquin (R-Maine), whose district narrowly went for Trump, praised it as "much needed health insurance relief."
Freshman Rep. John Faso (R-N.Y.) appeared open to supporting the bill but hasn't fully endorse it. "I'm certainly open to it, but remember what Ronald Reagan said about the Russians: trust but verify," he said.
House Republicans are also seeking to turn up the heat on Democrats, arguing that opposing the replacement bill will jeopardize their 2018 prospects.
"Democrats have suffered significant losses in recent election cycles, yet they still refuse to listen to the demands of their constituents," National Republican Congressional Committee (NRCC) Chairman Steve Stivers (Ohio) said.
"ObamaCare is failing, and Republicans are determined to replace it. Democrats can either join us or feel the repercussions again in 2018."
Still, Democratic campaign operatives feel as if Democrats have the upper hand on the healthcare issue and believe that the fallout gives them the opportunity to go on offense.
And groups like MoveOn.org, which have already organized rowdy protests at GOP lawmakers' town halls, say their efforts have been "supercharged" by the release of the bill.
MoveOn said protests were held Tuesday outside of lawmakers' offices in more than 60 cities nationwide. The group plans to ramp up its organizing for at least the next five weeks.
"I think in many ways, the 2018 elections are going to hinge on how the senators and representatives vote on this one bill," Ben Wikler, MoveOn's Washington director, told The Hill.
"Anyone thinking of supporting it should start polishing up their resume."