WASHINGTON — Senator Susan Collins of Maine said on Sunday that it was “very difficult” for her to envision voting for the latest plan to repeal and replace the Affordable Care Act, leaving President Trump and Republican leaders on the precipice of failure in their 11th-hour attempt to assemble the votes they need.
“I have a number of serious reservations about it,” Ms. Collins said on CNN’s “State of the Union.”
Her comments came two days after Senator John McCain, Republican of Arizona, announced that he would not support the measure. Another Republican, Senator Rand Paul of Kentucky, had previously said he would oppose it because he believed it did not go far enough in dismantling the Affordable Care Act — a critique he offered again on Sunday.
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Republican leaders in the Senate can afford to lose only two of their members in the narrowly divided chamber, and they have only six days to pass the bill in the Senate using procedures that shield it from a Democratic filibuster.
Ms. Collins was one of three Republicans who voted against the Senate’s previous repeal attempt, in July, along with Mr. McCain and Senator Lisa Murkowski of Alaska. Ms. Collins had previously expressed broad reservations about the new proposal, which was put forth by Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana.
“I’m concerned about the impact on the Medicaid program, which has been on the books for more than 50 years and provides health care to our most vulnerable citizens, including disabled children and low-income seniors,” Ms. Collins said on Sunday.
She added that she was also concerned about “the impact on cost and coverage,” as well as “the erosion of protections for people with pre-existing conditions like asthma, arthritis, cancer, diabetes and what it would mean to them.”
Still, she stopped short of declaring that she would vote against the measure, saying she wanted to wait for an analysis from the nonpartisan Congressional Budget Office that is expected to be released early this week.
The analysis is unlikely to transform her views. The budget office said last week that it was aiming to provide a preliminary fiscal assessment of the bill by early this week. But the budget office said that it would take at least several weeks to provide an analysis of the bill’s effects on health insurance coverage and premiums.
The Graham-Cassidy bill would repeal the expansion of Medicaid under the Affordable Care Act as well as the tax credits that are provided to help people buy insurance on the individual market. In their place, it would provide block grants to the states to use for health care.
It would also allow states to seek federal waivers that would allow insurers to charge higher premiums to people with pre-existing medical conditions and to omit certain benefits, like maternity care and mental health care, that they are currently required to offer.
On NBC’s “Meet the Press,” Mr. Paul reiterated his view that the bill was “not repeal.” He expressed willingness to support a narrower repeal measure, but made clear that he objected to the central premise of the Graham-Cassidy bill.
“I’m just not for block-granting Obamacare,” Mr. Paul said, “and calling it a day.”
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