Sens. Rand Paul, R-Ky., and John McCain have already said they intend to vote against the Affordable Care Act change bill.
Collins said in a statement about her decision that there appear to be at least four versions of the Graham-Cassidy proposal in circulation.
“Sweeping reforms to our health care system and to Medicaid can’t be done well in a compressed time frame, especially when the actual bill is a moving target,” Collins said. “The fact that a new version of this bill was released the very week we are supposed to vote compounds the problem.”
Collins said she objects to Graham-Cassidy because she believes it would make devastating cuts in Medicaid funding; weaken commercial health insurance protections for people with pre-existing conditions; and lead to higher commercial health insurance premiums and reduced coverage access.
The Graham-Cassidy bill would replace the current Affordable Care Act Medicaid and individual major medical insurance subsidy programs with grants for states, and it would let states apply to adjust the current Affordable Care Act major medical insurance standards.
Republicans have just 52 seats in the Senate and need at least 50 votes to pass a bill. If Collins, Paul and McCain continue to oppose Graham-Cassidy, and no Democrat or independent crosses party lines to vote for it, the bill will die.
After Collins came out against the bill, Senate Majority Leader Mitch McConnell tweeted comments implying that he believes prospects for passing the bill are bleak. Sen. Orrin Hatch, R-Utah, chairman of the Senate Finance Committee noted that the bill has no Democratic votes. But, in the House, in the spring, Republican leaders managed to get another Affordable Care Act change bill, H.R. 1628, passed after first going through a stinging loss on the House floor.
Collins issued her statement shortly after the Senate Finance Committee concluded a hearing on the bill, and shortly before analysts at the Congressional Budget Office gave a preliminary assessment of the bill.
Two of the lead sponsors — Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La. — spoke in favor of the bill at the Senate Finance hearing.
Rick Santorum, a former Republican senator from Pennsylvania, also testified on behalf of the bill.
Graham, Cassidy and Santorum talked about why states should have flexibility to adjust the Affordable Care Act, and why they believe the Graham-Cassidy grant formula would be fair.
Dennis Smith, an official who managed Medicaid under former President George W. Bush, was the only witness supporting the bill who talked about why he thought the provisions in the bill would work.
Dennis Smith (Photo: Senate Finance)
Smith, who is now a senior advisor for Medicaid and health care reform at the Arkansas Department of Human Services, said the Graham-Cassidy grant program would help the individual major medical insurance market by giving states the ability to combine the individual major medical risk pool with the Medicaid risk pool.