WASHINGTON (CBS) — The Senate plan to repeal and replace Obamacare is in trouble after a fifth Republican senator came out against it.

Sen. Dean Heller, R-Nevada, announced Friday he can’t support the plan because it rolls back Obamacare’s expansion of Medicaid and puts federal funding limits on the program.

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“You have to protect Medicaid expansion states. That’s what I want, make sure that we’re taken care of here in the state of Nevada,” said Heller.

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Already, Sens. Rand Paul, Ted Cruz, Ron Johnson and Mike Lee say the newly released Senate health care plan is dead on arrival, unless they see some major changes.

The four are sticking together to get changes, such as fewer government subsidies designed to make health insurance more affordable.

“As we estimate the cost of the subsidies to buy insurance, we actually believe they may exceed, or at least equal, the subsidies that are under Obamacare,” said Paul.

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President Donald Trump will help lead talks to get the reluctant Republicans on board.

“Well, they are also four good guys and they are four friends of mine,” said Trump. “I think that they’ll probably get there, but we’ll have to wait and see.”

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The problem facing GOP leaders is that any changes that moves the bill further to the right has the potential to alienate moderate Republicans.

“I cannot support a piece of legislation that takes insurance away from tens of millions of Americans and hundreds of thousands of Nevadans,” said Heller.

Senate Majority Leader Mitch McConnell insists he wants a vote before the Fourth of July recess, leaving GOP leaders one week to win over more votes.

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Not one Democrat plans on supporting the bill, which means Republicans can only afford to lose two more votes in the Senate or the bill will fail.