Nevada Gov. Brian Sandoval is putting in writing his opposition to a GOP proposal to rework federal health laws.
Sandoval was one of four moderate Republican governors who signed a letter Thursday saying the plan would leave out too many people.
The GOP proposal would cut the federal government's share of Medicaid in states like Nevada that expanded the program.
The governors say that breaks President Donald Trump's pledge to provide states ample Medicaid resources and flexibility.
Sandoval, Ohio Gov. John Kasich, Michigan Gov. Rick Snyder and Arkansas Gov. Asa Hutchinson signed the letter to congressional leaders.
They propose states get the ability to tailor and freeze enrollment in Medicaid.
Meanwhile, far-right Republicans are pushing for more cuts and Health Secretary Tom Price is urging them to "collaborate."