Sen. Susan Collins, R-Maine

In a move that likely dooms the Republican health care overhaul, U.S. Sen. Susan Collins said Monday it is “as deeply flawed” as several other GOP versions over the summer so she will oppose it.

Without her backing, the latest bid to overturn the Affordable Care Act appears to be dead.

Collins, the senior senator from Maine, was not swayed by a last-minute bid to try to pump more money into the measure’s proposed Medicaid allotment for Maine between 2020 and 2026.

“The fact is, Maine still loses money under whichever version” of the bill pushed by her colleagues Lindsey Graham of South Carolina and Bill Cassidy of Florida is eyed, Collins said.

“The bills use what could be described as a ‘give with one hand, take with the other’ distribution model,” Collins said in a prepared statement. “Huge Medicaid cuts down the road more than offset any short-term influx of money.”

“But even more important, if senators can adjust a funding formula over a weekend to help a single state, they could just as easily adjust that formula in the future to hurt that state,” she said. “This is simply not the way that we should be approaching an important and complex issue that must be handled thoughtfully and fairly for all Americans.”

Two of the other 52 GOP senators — Kentucky’s Rand Paul and Arizona’s John McCain — have said they won’t vote for it. So the addition of Collins to their ranks effectively bars the Republicans from securing the majority they need in the 100-member Senate.

The bill, which Senate leaders hoped to pass this week, would slice as much as $1 trillion off projected Medicaid spending during the next two decades.

Collins said that she is “really concerned about continued coverage and protection for people with pre-existing conditions” if the measure is adopted. That’s a problem in states that may not offer protection to their residents. Maine law, however, does.

The Maine senator also said she’s worried that premiums, already high, would become unaffordable for many.

Alaska Republican Lisa Murkowski, who voted with Collins and McCain to kill an earlier plan in July, is also skeptical of the new plan that GOP leaders hope to pass before a Sept. 30 deadline for securing Senate support by majority vote. After that, they are likely to need 60 votes to push through a plan, a number they can’t reach without securing some Democratic backing.

President Donald Trump is among those trying to put pressure on Collins to endorse the Cassidy-Graham bill.

In a published statement on Twitter Sunday, the president wrote, “Alaska, Arizona, Maine and Kentucky are big winners in the Healthcare proposal. 7 years of Repeal & Replace and some Senators not there.” It is not clear why the president said that Maine would be among the big winners.

“Instead of trying to buy off Sen. Collins’ vote to pass an unpopular bill that would take away health care from millions of people, Republicans should work with Democrats to improve the ACA for all Americans,” Maine Democratic Party Chairman Phil Bartlett said Monday.

National organizations representing hospitals, doctors and insurers oppose the bill, including the American Medical Association and the American Hospital Association. The Maine Hospital Association is also against its passage.

It said Maine would wind up with about $1 billion less in federal aid through 2027, a reduction it argued would be particularly tough on rural hospitals.

Collins said on television that she wants to see an upcoming analysis from the Congressional Budget Office before making a final decision. Unless it differs dramatically from independent studies released in recent days, there’s no reason to think it will shift her toward supporting the bill.

“I actually expect that CBO is either going to reinforce” those recent studies “or that CBO is going to say that they simply don’t have the time to do a thorough analysis,” Collins said.

Cassidy said Monday on CNN “there will be a billion dollars for Mainers who are lower-income to have coverage, which they do not now have, by the way.”

He called it “a heck of a lot” in an interview with The Washington Post.

“It’s not for Susan, it’s for the Mainers. But she cares so passionately about those Mainers, I’m hoping those extra dollars going to her state .?.?. would make a difference to her,” Cassidy said.

U.S. Sen. Angus King, a Maine independent, said the extra money for Maine that Cassidy sought to add “is merely an attempt to use small, short-term gains to hide the fact that Graham-Cassidy’s plan to cap Medicaid would have severe long-term consequences for Maine’s aging population and our rural hospitals, in addition to threatening affordable access to coverage for millions of Americans.”  

Collins worked hand-in-hand with Cassidy for much of the year on a health care bill she hoped would attract bipartisan backing. It never caught on.

It’s worth noting that when Cassidy moved on to ally with Graham instead, a move that helped lock in more conservative senators with a much more restrictive bill that would fundamentally change the way Medicaid operates, Collins didn’t go along with him.

She said Sunday that “the Medicaid program has been on the books for more than 50 years. The Graham-Cassidy bill proposes a dramatic sweeping change in the way that program would be allocated and administered.”

She said Medicaid needs revision but it ought to be “careful reform.”

“I don’t think this bill does that,” Collins said.

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