Republican Sen. Dean Heller — who has faced fire from both the left and the right essentially every time he has opened his mouth on health care over the last couple of months — offered on Monday afternoon a brief defense of a bill he’s sponsoring to repeal and replace Obamacare, a last-ditch effort that seemed headed to its grave only an hour later.

In five minutes of prepared remarks he delivered during the more than five-hour long meeting, Heller reiterated his view that the legislation, which would block grant federal Obamacare funding to states while making deep cuts to the half-century old Medicaid program, empowers states to develop their own health-care solutions. To prove his point, Heller lobbed a series of questions at fellow bill sponsor Bill Cassidy, a Republican senator from Louisiana who bore the responsibility of defending the legislation to the Senate Finance Committee Monday afternoon, in an attempt to emphasize that Nevada could continue to deliver health care in the way it does under the Affordable Care Act, should it so choose.

“Does this legislation give Nevada more dollars with more flexibility,” Heller asked Cassidy.

“Correct,” Cassidy said.

Flexibility is the key word Heller has hammered home in his statements and comments about the legislation, which the Republican senator signed onto as an alternative to Senate Republicans’ last repeal-and-replace proposal amid a tense week of health-care discussions in late July. Describing himself as a “small government conservative,” Heller told the committee that any solution to the nation’s health-care problems “needs to be rooted in increased flexibility.”

“When these senators came to me with an idea that would fundamentally change the way our health-care system works, when they told me this plan offered Nevada more flexibility and more funding to meet the needs of our patients, I said, ‘Sign me up,’” Heller said. “Our proposal represents what I set out to do from the very beginning of this summer's health-care debate, and that's to do what’s best for the state of Nevada, the citizens in our state and across this country.”

The nonpartisan Congressional Budget Office released its preliminary analysis of the legislation on Monday, estimating that the legislation would reduce the federal budget deficit by at least $133 billion between 2017 and 2026 but that “millions fewer” would have health-care coverage. It also estimated that federal spending on Medicaid would be reduced by $1 trillion over the same period.

Gov. Brian Sandoval, who stood alongside Heller in June to condemn the last repeal-and-replace proposal, sharply split from his Republican colleague last week, saying that “flexibility with reduced funding is a false choice.” Various independent groups pegged the reduction in federal spending in Nevada somewhere between $600 million and $2 billion if the version of the so-called Graham-Cassidy proposal in circulation last week were to pass.

But under a new version of Graham-Cassidy circulated over the weekend and publicly discussed on Monday, it appears as if Nevada actually might not lose any federal funding, at least under the block grant portion of the bill. The new draft makes tweaks to the way the block grant is divided up among the 50 states, giving some states a little bit more at the expense of other states.

Calculations released by the bill’s sponsors estimate that Nevada stands to receive about $13.29 billion between 2020 and 2026 if the Affordable Care Act remains in place. Under the earlier draft, Nevada would have only received about $11.95 billion over that time frame, about a 10 percent decrease, where it is now estimated to receive $13.37 billion, about a one percent increase, under the latest draft.

Proponents of the legislation also estimate that Nevada would save an additional $1.16 billion by not having to pay the matching dollars it does to receive federal dollars through Medicaid expansion, a program Sandoval opted Nevada into in 2012 to fill in coverage gaps for Nevada’s low-income population. It is unclear whether Nevada would cut that portion from its budget or simply allocate the dollars more generally toward the state’s health-care programs.

A spokeswoman for Sandoval's office said Monday night that the governor has asked the Department of Health and Human Services and staff to review and analyze the bill. Heller’s office also did not respond to a request for comment.

The independent groups that have conducted analyses of Graham-Cassidy over the last week did not immediately release their updated projections on Monday. However, the left-leaning Center on Budget and Policy Priorities, which has conducted some of the more extensive analysis on the legislation, noted that the calculations released by the bill’s sponsors do not include the cuts states would face under the Medicaid per capita cap, which will worsen for states over time.

Last week, The Nevada Independent obtained a state analysis of the earlier draft of Graham-Cassidy in which the state agreed the per capita cap that the legislation places on Medicaid funding would “fundamentally” change the federal Medicaid program without taking into consideration long-term impacts to the state. The state noted that outside organizations who have analyzed the bill have generally concluded that the adjustments it makes for various types of inflation will not keep pace with the actual costs of providing health care year over year.

Opponents of the legislation have also noted that there is no guarantee that states will receive any funding from the block grant starting in 2027, which means states could be facing significant gaps in their budget should Congress choose to not authorize the funding.

As of Monday night, the future of the legislation seemed grim. Republican Sen. Susan Collins of Maine all but killed the legislation Monday afternoon, announcing that she would vote against the measure, joining Arizona Sen. John McCain and Kentucky Sen. Rand Paul in opposition. Republicans can only afford to lose two members of their caucus on the legislation in order for it to pass, as all Democrats are expected to vote against the legislation.

Minutes before Collins’ announcement, Heller told Politico he expected there would be a vote on the legislation.

“It will succeed and I’m voting for it,” Heller said. “It’s called optimism.”