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Susan Collins a No Vote on Graham-Cassidy Repeal and Replace Plan

Bill Cassidy,Susan Collins

Republican Sen. Susan Collins (Maine) announced Monday evening that she opposes the Graham-Cassidy health care bill, effectively sinking the GOP's last effort to repeal and replace Obamacare.

Collins' statement outlines several major concerns with the bill, pointing to projections of cuts to Medicare and the possibility of "weaken[ed] protections for people with pre-existing conditions" as issues that made her a no vote.

The bill, named for authors Sen. Lindsey Graham (R., S.C.) and Sen. Bill Cassidy (R., La.), is meant to repeal and replace Obamacare by transferring most responsibility for health care services to the states. Senate Republicans have until Sept. 30 to pass it in their last-ditch effort to overturn Obamacare. However, Graham and Cassidy have struggled to put together the required 50 votes, with Sens. John McCain (R., Ariz.) and Rand Paul (R., Ky.) joining the 48 Democratic senators in opposition.

Collins now joins her colleagues from Arizona and Kentucky, outlining three reasons for her no vote.

"Both proposals make sweeping changes and cuts in the Medicaid program. Expert projections show that more than $1 trillion would be taken out of the Medicaid program between the years 2020 and 2036," Collins said. "This would have a devastating impact to a program that has been on the books for 50 years and provides health care to our most vulnerable citizens, including disabled children and low-income seniors."

"Second, both bills open the door for states to weaken protections for people with pre-existing conditions, such as asthma, cancer, heart disease, arthritis, and diabetes," she said. "States could also limit specific categories of benefits for Affordable Care Act policies, such as eliminating coverage for mental health or substance abuse treatment."

The third concern Collins explained was the lack of support for Graham-Cassidy from physicians, insurers, and hospitals. The bill is opposed by, among others, the American Medical Association and state-level Medicaid directors.

"Third, physicians, patient advocates, insurers, and hospitals agree that both versions of this legislation would lead to higher premiums and reduced coverage for tens of millions of Americans," Collins said.

Collins also addressed the most recent version of the bill, which allocated more money to Maine and other states in what some see as a ploy to win reticent votes. She attacked the bill as having a "'give with one hand, take with the other' distribution model," saying that 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."

Collins acknowledged the flaws of Obamacare, and promised that she would continue to work to address the struggles of individuals and businesses.

"The Affordable Care Act has many flaws that need to be addressed," she said.  "The current state of health insurance, where premiums are skyrocketing, choices are limited, and small businesses are struggling, needs fixing. My focus will remain on remedying these problems."