The standard set by Sen. Susan Collins was straightforward: A Senate bill should not reduce the number of people with health insurance. It should not raise costs or put rural hospitals at risk.
A Senate bill to repeal the Affordable Care Act fails all these tests, according to an analysis released Monday by the Congressional Budget Office.
This prompted Collins to quickly announce that she would vote against proceeding to debate on the Better Care Reconciliation Act. Her quick, and appropriate, opposition prompted Senate leadership to delay a vote, which had been scheduled for before the July 4 recess. Sen. Angus King, an independent, has long opposed repealing the ACA.
Collins’ definitive opposition has, for now, stalled a dangerous, secretive bill that would have stripped millions of health insurance, raised costs for millions more, eliminated health care jobs and weakened special education programs, all to give big tax breaks to the wealthy.
Collins summed up her opposition in three tweets Monday evening. “I want to work w/ my GOP & Dem colleagues to fix the flaws in ACA. CBO analysis shows Senate bill won’t do it. I will vote no on [motion to proceed],” she wrote in the first.
Then came her reasons: “CBO says 22 million people lose insurance; Medicaid cuts hurt most vulnerable Americans; access to health care in rural areas threatened.”
“Senate bill doesn’t fix ACA problems for rural Maine. Our hospitals are already struggling. 1 in 5 Mainers are on Medicaid,” she said in the tweets.
This strong opposition is well placed, as is Collins’ unusual move to oppose beginning debate on the bill because it is so flawed.
We fear that Senate Republican leaders will continue to try to ram this legislation through without the support of moderates like Collins. This is what happened in the House. When a significant number of conservative representatives said they would not support the bill, it was tweaked to bring them back on board. Nothing was done to earn the votes of 20 moderate House Republicans who voted against the bill. It was approved by a 217-214 vote.
The calculus is more difficult in the Senate where Republicans hold 54 seats. Several moderate Republicans in the Senate, plus a few conservative Republicans, have said they oppose the Senate bill. Vice President Mike Pence, who could cast a crucial 51st vote in the Senate, is on a road trip to meet with wavering Republicans. President Donald Trump met with Republican senators at the White House on Tuesday in hopes of gaining more support for the repeal bill. Collins and Alaska Sen. Lisa Murkowski, who has also spoken out against the bill, sat next to the president.
At the same time, the Departments of Labor and Homeland Security are hurriedly issuing visas to allow immigrant workers for the hospitality industry in Maine and the fishery in Alaska, ProPublica reported.
Collins said Trump listened intently to the concerns she and other senators raised. But, she was skeptical that her profound concerns could be addressed by simply changing the Senate bill.
“I would say that I have so many fundamental problems with the bill that have been confirmed by the CBO report, that it’s difficult for me to see how any tinkering is going to satisfy my fundamental and deep concern about the impact of the bill,” she said after the White House meeting.
Her concerns about unaffordable deductibles and premiums and radical changes to Medicaid are shared by the American people. Her warnings about the consequences for rural hospitals aren’t unique to Maine.
Failing to address these underlying problems is a huge defect of both the Republican House and Senate bills.
The problem is much more about politics than health care. Many Republicans ran on platforms of repealing Obamacare, their derisive name for the Affordable Care Act. So did President Donald Trump. They fear the political consequences of not keeping this campaign pledge.
Lawmakers have tried the easy route — working to repeal the ACA and replace it with something much worse before the American public fully understood what was happening. But the public has caught on.
Collins has the right solution — fixing the flaws in the ACA. This is better than throwing it out and replacing it with something much worse for the American people and our economy.