Sen. Dean Heller (R-Nev.) on Friday offered a harsh assessment of Senate Republicans health care bill and vowed to withhold his support for it unless it is altered significantly.

Speaking at a joint press conference with Nevada Gov. Brian Sandoval (R) in Las Vegas, Heller said the Senate bill must protect states, like his, that expanded Medicaid and preserve gains in coverage that resulted from the Affordable Care Act .

In this form, I will not support it, Heller said. Its going to be very difficult to get me to a yes. They have a lot of work to do.