The latest Republican health-care bill gives significant power to the states. But several of the nation’s governors, including a handful of Republicans, aren't interested.

An analysis of statements signed by governors and The Washington Post's current whip count on the bill shows that nine Republican senators are likely to diverge from their state's governor on the bill, including two of the bill's four co-sponsors. A third co-sponsor lacks his governor’s support on the measure, while the governor is reviewing the bill.


Unsurprisingly, the bill’s primary author, Sen. Bill Cassidy (La.), finds himself in opposition to his state’s Democratic governor, John Bel Edwards. South Carolina’s Republican governor, Henry McMaster, is mulling over the bill, despite his senators’ support for it — including another co-sponsor, Sen. Lindsey O. Graham (more on that below).

Only less-visible co-sponsor, Sen. Ron Johnson (R-Wis.), has the explicit support of his governor, Scott Walker.

The situation gets more interesting in Alaska and Nevada, whose moderate independent and Republican governors, respectively, oppose the bill.

In Arizona and Maine, conservative governors Doug Ducey and Paul LePage want the bill passed, but senators from their states have voiced concerns.

One reason state executives are reluctant to support the measure: Many stand to lose billions of federal health-care dollars, according to a Kaiser Family Foundation study released Thursday. Many of the governors who support the bill run one of the 15 states that would see a funding increase.


The states that stand to gain — many of the states highlighted above — did not expand Medicaid under the Affordable Care Act.

Here are some places where governors and senators are in conflict:

Nevada
Sen. Dean Heller (R), another co-sponsor of the legislation: Supports
Gov. Brian Sandoval (R): Opposed

The moderate Heller voiced concerns about the last health-care bill, but he has been much more supportive of this one, signing on as a co-sponsor. He might be the most vulnerable Republican running in 2018 and is contending with a primary challenge from the Trump wing of the party.

Sandoval signed on to a letter this week from multiple governors opposing the bill. He later put out a separate statement saying, “I know that Senator Heller is working in the best interest of the state,” but noting that the work of a bipartisan group of governors to shore up the existing ACA marketplaces was the best way forward.

South Carolina
Sen. Lindsey O. Graham (R), one of the sponsors of the bill: Supports
Gov. Henry McMaster (R): Uncertain

In August, Graham suggested his bill could succeed because of the support of governors, saying, “I'm hoping to have 25 Republican governors come out the next couple of weeks.” But his own governor has withheld support for the bill.

“I’m studying it. I think most anything would be better than Obamacare, but I have had several conversations with Sen. Graham and the vice president and a few others, and we’re studying it very closely,” McMaster told a South Carolina paper this week.

The state's other Republican senator, Tim Scott, has also voiced support for the bill.

Arizona
Sen. John McCain (R), a “no” vote on the last Senate health bill: Concerned
Gov. Doug Ducey (R): Supports

McCain downed the last version of the health-care bill in dramatic fashion, later saying on a Phoenix-based radio show that “Arizona was about to get screwed.” Paige Winfield Cunningham has more analysis on McCain's thinking on the last bill here.

In July, McCain said he would defer to his governor when it came time to take a vote, a sentiment he reiterated Monday.

But McCain also told The Post in a statement, “As I have said all along, any effort to replace Obamacare must be done through the regular order of committee hearings, open debate and amendments from both sides of the aisle.”

This bill is certainly not following “regular order” — whatever that means — and it's unclear whether that will stop McCain from voting for it.

Maine
Sen. Susan Collins (R), another “no” on the last bill: Concerned
Gov. Paul LePage (R): Supports

Collins and LePage come from two very different wings of the Republican Party, the former a moderate Republican who refused to support Donald Trump, the latter a conservative firebrand very much in the mold of the president. This Bangor Daily News story details their fraught relationship.

LePage warned in a radio interview last month that Collins, who is reportedly considering a run to replace LePage in 2018, was “highly unlikely” to win a Republican primary.

The governor railed against the moderate Republican senator at a Saturday pig roast put on by the Somerset County Republican Committee in Canaan, where an attendee said LePage repeatedly mentioned working to defeat Collins if she runs for governor next year.

Whether Collins, McCain and others choose to buck their governors' wishes will determine the bill's fate.