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Dean Heller's newest health care dilemma

Rebecca Zisser / Axios

The Nevada senator's torturous rendezvous with health care politics isn't over. Of the 17 counties listed in the latest Centers for Medicare and Medicaid Service map that might have no Affordable Care Act insurers at all next year, 14 were in — you guessed it — Nevada.

Context: Sen. Lamar Alexander, chairman of the Senate health committee, and Democratic Sen. Patty Murray are pushing hard for a bipartisan short-term stabilization package in September. Conservative groups have all but already branded such a package an "insurer bailout."

Heller — up for re-election next year — is just two weeks removed from the debacle of the GOP's health care bill, where he started as an opponent but ended up not taking much of a firm stance on anything.

What's next: Nevada is a purple state that went for Hillary Clinton, and two different former GOP Senate aides told me without hesitation that Heller should make sure he's part of any individual market stabilization effort. But Heller has a primary opponent from the right, and it's already become a given that he misplayed his hand over the last few months.

The lesson from the past is that Nevada's bare counties don't necessarily indicate how Heller will behave next month.

"It appears that the Alexander-Murray duo is going to come up with something, and I would work pretty hard to make sure I was in the middle of that and getting as much public attention for my work on that as I could if I was Dean Heller," said one of the former aides. "He needs to be seen as part of the solution."

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