THE BURNED OVER DISTRICT

The widespread opposition of state governors, Republican and Democrats, would have effectively put an end to any more discussion of Mitch's Killer "Health Care" Bill. Back then state legislatures selected who would be Senator and they were often on the same page as the governor on this.

The nation’s governors, gathered here for their annual summer meeting, came out strongly on Friday against the new Senate bill to repeal the Affordable Care Act, turning up the pressure on Republican leaders struggling to round up the votes to pass the bill next week.

Opposition came not just from Democratic governors but from Republicans who split along familiar lines — conservatives who said the legislation did not go far enough and moderates who said it was far too harsh on their state’s vulnerable residents.

Gov. Brian Sandoval of Nevada, who at the moment may be the most pivotal figure in the health care debate, said he had “great concerns” with the legislation, and all but declared that he could not support any bill that would scale back Nevada’s Medicaid program. His decision to expand Medicaid under the Affordable Care Act had been “a winner for the people of our state,” he said of the government health insurance program for poor and disabled people.

“I have to be comfortable that those 210,000 lives are going to continue to enjoy the quality of life and health care that they have right now,” he said, referring to the number of Nevadans who gained coverage through the expansion of Medicaid under President Barack Obama’s signature health law.

Conservative governors were not much more supportive. Gov. Scott Walker of Wisconsin suggested that Congress consider a better-funded version of the measure proposed this year by two Republican senators, Susan Collins of Maine and Bill Cassidy of Louisiana, that would offer states more flexibility over how to run their health care programs.

Pursuing that approach, Mr. Walker said, would obviate differences between the states that did and did not expand Medicaid while averting the intractable split between conservative and centrist members of Congress over how to structure a replacement. “None of these plans right now do us justice,” he said.

The response mirrored the struggles of congressional Republicans to forge consensus on legislation that would make good on a seven-year vow to repeal the health law. With two Senate Republicans already opposed, Senate leaders cannot lose any additional votes, and on Friday, some of the most influential Republican governors indicated a willingness to torpedo the bill entirely.

Mr. Sandoval’s views are likely to influence Nevada’s Republican senator, Dean Heller, while Mr. Walker’s could play on Wisconsin’s undecided Republican, Ron Johnson.

The threat of governor's to put someone else in the Senate is no longer quite so direct but still formidable in some states. It remains to be seen which Senators will get in line with their states.