U.S. Sen. Susan Collins, R-Maine, speaks with a reporter as she arrives for a vote at the Capitol in Washington, Tuesday, Sept. 19. Top Senate Republicans say their last-ditch push to uproot former President Barack Obama’s health care law is gaining momentum. Collins voted against the previous GOP health care attempt. 

While it’s clear that U.S. Sen. Susan Collins is skeptical of the latest effort by Republicans to repeal the Affordable Care Act, she hasn’t yet taken a stand despite growing pressure on her to oppose the bill.

The Maine Republican is one of a few senators whose vote might decide the fate of the proposal by U.S. Sens. Bill Cassidy, R-Louisiana, and Lindsey Graham, R-South Carolina. It calls for slicing projected Medicaid increases and allowing states to permit insurers to charge higher premiums for people with preexisting conditions, including pregnancy.

Collins was one of four GOP senators whose opposition killed efforts in July to adopt a health care bill aimed at overhauling President Barack Obama’s signature legislation, often referred to as Obamacare.

Maine’s other U.S. senator, independent Angus King, criticized Republicans for trying once again to wipe out the ACA.

King said that all summer in Maine, he heard from people thanking him for opposing the Republican plans in July and even telling him to pass on their thanks to Collins for her stance as well.

“Yet here we are, back at it again,” he said.

Critics of Obama’s health care program are making one last push because they face a Sept. 30 deadline to pass something under a budget reconciliation rule that allows the Senate to enact a measure by majority vote. After that, it would need to garner 60 votes under existing Senate rules.

President Donald Trump said in a statement on Twitter on Wednesday that he hopes Republican senators “will vote for Graham-Cassidy and fulfill their promise to Repeal & Replace ObamaCare. Money direct to States!”

This time around, only one Republican, Kentucky’s Rand Paul, has said he won’t vote for the bill.

Trump called him “a negative force.”

At least two other GOP senators need to join him to block its passage.

Collins told reporters she is “concerned about what the effect would be on coverage, on Medicaid spending in my state, on the fundamental changes in Medicaid that would be made without the Senate holding a single hearing to evaluate them. And also on what the effect would be on premiums, particularly for older Americans between 50 and 64.”

She said she will examine a Congressional Budget Office analysis carefully when it comes out early next week.

Collins also said she is “very concerned by projections cited by the Maine Hospital Association, which show the bill would cut Medicaid and other federal health care spending in Maine by more than $1 billion in the next 10 years.”

The Maine Hospital Association said the Cassidy-Graham bill is similar to the ones that Collins opposed in July. It includes Medicare cuts to hospitals while also reducing Medicaid funding, the association said.

“Rural Maine people and the hospitals that provide them care are disproportionately reliant on Medicaid,” it pointed out.

Though medical providers generally oppose the measure, Gov. Paul LePage backs it. He urged Mainers to let Collins and King know their position this week by phoning their offices.

Both offices, though, said they are mostly hearing from opponents.

On Wednesday, LePage used his weekly radio address to blast Maine’s senators.

“We have one last shot to get the votes in the United States Senate to save the health care system from total collapse or a big government takeover,” the governor said. “Unfortunately, Maine’s two senators have been opposing efforts to reform ObamaCare since day one.”

LePage said Collins and King “just want another massive expansion of Medicaid. They want to give free health care to able-bodied people who should be working and contributing toward their health insurance.”

Democrats have a different take. U.S. Rep. Chellie Pingree, a 1st District Democrat, said the Cassidy-Graham proposal is “the worst version of TrumpCare yet.”

The Maine Small Business Coalition said Wednesday that Collins ought to vote against “this terrible amendment” that would gut the ACA, which it said has been a boon for Maine’s economy.

King said there have been “real discussions” recently among senators about possible bipartisan fixes to the ACA that would help ensure that people can get insurance at a reasonable price.

“Then, all of a sudden, up comes TrumpCare 4.0 or 5.0 — I have lost track — another bill to essentially repeal and not replace the Affordable Care Act,” King said.

Echoing the words used to describe the way Union troops fled in chaos at the first battle of Bull Run in the Civil War, King called the move away from trying to fix the ACA “the Great Skedaddle.”

“This is the great health care skedaddle, because what the Senate majority is doing is avoiding responsibility,” King said, shifting responsibility for dealing with preexisting conditions, age discrimination in premiums and other issues to the states. He called it “a cop-out.”

“It is the Senate majority once again trying to jam down the throats of the American people a change they don’t want,” he said.

“This is not a responsible way to legislate, and the people of this country expect more of us,” King said. “I hope both parties — both parties — will recognize the folly of what is being proposed here and say no,” King said. “Then, let’s go back to talking, on a bipartisan basis, and fix the problems with the American health care system, which certainly need to be addressed.”

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