Graham-Cassidy bill nears collapse with Sen. Collins' opposition

Sen. Susan Collins, R-Maine, announced  her opposition to the Graham-Cassidy bill Monday, giving the proposal its third official Republican "no" vote and likely ending its chances for passage.

Ms. Collins joins Sen. Rand Paul, R-Ky., and Sen. John McCain, R-Ariz., in publicly opposing the bill, which sought to eliminate the ACA's marketplace subsidies and enhanced matching rate for Medicaid expansion, starting in 2020, and replace those funds with block grants that states could use for health coverage or any other healthcare purpose.

Ms. Collins said she could not support the bill because of its cuts to Medicaid, its allowances for states to waive certain essential health benefits and its negative effects on coverage rates and premiums.

"Healthcare is a deeply personal, complex issue that affects every single one of us and one-sixth of the American economy. Sweeping reforms to our healthcare system and to Medicaid can't be done well in a compressed time frame, especially when the actual bill is a moving target," Ms. Collins wrote.

With budget reconciliation rules that expire Sept. 30, the GOP could pass healthcare legislation with 50 votes, with Vice President Mike Pence acting as a tiebreaker. However, with the announcement of Ms. Collins' opposition, they have only 49 votes. Ms. Collins, along with Mr. McCain and Sen. Lisa Murkowski, R-Alaska, sided with Democrats to vote against the Republican "skinny" repeal in July, defeating the bill 51 to 49.

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