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Sen. Collins Likely Against Health Bill09/24 12:49

   WASHINGTON (AP) -- Sen. Susan Collins all but closed the door Sunday to 
supporting the last-ditch Republican health care bill, leaving her party's 
drive to uproot President Barack Obama's health care law dangling by an 
increasingly slender thread.

   Already two GOP senators, Rand Paul of Kentucky and John McCain of Arizona, 
have said they would vote against the legislation. All Democrats oppose the 
measure, so "no" votes from three of the 52 GOP senators would kill the party's 
effort to deliver on its perennial promise to repeal "Obamacare."

   "It's very difficult for me to envision a scenario where I would end up 
voting for this bill," said Collins, a Maine moderate.

   Collins' all but certain opposition leaves the White House and party leaders 
desperate to rescue their promise to repeal Obama's Affordable Care Act with 
one immediate option: trying to change the mind of at least one opponent.

   Republicans have said they're still reshaping the bill in hopes of winning 
over skeptics. Collins said sponsors were making last-minute adjustments in the 
measure's formulas used to distribute federal money to the states, and the 
measure's sponsors said they still intended to plow ahead.

   "So yes, we're moving forward and we'll see what happens next week," said 
one of the authors, Sen. Lindsey Graham, R-S.C.

   Paul criticized the GOP bill anew as "not repeal." He said he opposed a key 
pillar of the legislation --- transforming much of the federal spending under 
Obama's law into block grants of money that states could spend with wide 
latitude. He said the GOP bill left too much of that spending intact and simply 
gave states more control over it.

   "Block granting Obamacare doesn't make it go away," Paul said.

   Collins said she had a lengthy conversation Saturday with Vice President 
Mike Pence, who she said urged her "to think more thoroughly about some 
issues." Graham suggested backing a proposal sought by Paul that would make it 
easier for people to join or form group insurance plans so they would have 
lower premiums.

   Collins said she was troubled by the bill's cuts in the Medicaid program for 
low-income people. She expressed concerns that the measure would result in many 
people losing health coverage and didn't like a provision letting states make 
it easier for insurers to raise premiums on people with pre-existing medical 

   As GOP leaders scramble for votes, a chief target is Sen. Lisa Murkowski, 
R-Alaska, whose state has unusually high health care costs because of its many 
remote communities. Collins and Murkowski were the only Republicans who voted 
"no" on four pivotal votes on earlier versions of the GOP legislation this 

   Murkowski has remained uncommitted on the newest bill, saying she's studying 
its impact on Alaska. Her state's officials released a report Friday citing 
"unique challenges" and deep cuts the measure would impose on the state.

   A showdown vote would have to occur this week to give Republicans any shot 
at reversing their debacle on the issue in July, when the GOP-run Senate 
rejected their initial attempt to dismantle Obama's law. When September ends, 
Republicans will lose procedural protections that have blocked Democrats from 
successfully stalling the bill; after that, Republicans would need 60 votes to 
move ahead.

   White House legislative liaison Marc Short said he expected a vote to occur 

   Senate Majority Leader Mitch McConnell, R-Ky., has said he intends to have a 
vote this coming week but has stopped short of firmly committing to it. If 
party leaders expected to lose, they would have to choose between conservatives 
demanding no surrender in the GOP's attempt to scrap the law and others seeing 
no point in another demoralizing defeat.

   The renewed GOP drive has encountered widespread opposition from health 
industry groups, which have strongly opposed the effort.

   On Saturday, organizations including America's Health Insurance Plans 
representing insurers, the American Hospital Association and the American 
Medical Association released a statement urging the Senate to reject the 
legislation. They wrote that the bill would leave the individual health 
insurance market "drastically weakened," cause "drastic cuts" in Medicaid and 
undermine safeguards" for people with pre-existing medical conditions.

   This summer's setback infuriated the party's core conservative voters and 
prompted President Donald Trump to unleash a series of tweets blaming McConnell 
for the failure and goading him to keep trying. In recent days, Trump has 
tweeted that McCain was sold "a bill of goods" against the bill by Democrats 
and that any GOP senator voting against the bill would be known as "the 
Republican who saved ObamaCare."

   The bill would repeal much of the 2010 law, including its tax penalties on 
people who don't buy insurance and on larger employers not offering coverage to 
workers. States could loosen coverage requirements under the law's mandates, 
including prohibiting insurers from charging seriously ill people higher 
premiums and letting them sell policies covering fewer services.

   It would eliminate Obama's expansion of Medicaid and the subsidies it 
provides millions of people to reduce their premiums and out of pocket costs, 
substituting block grants to states.

   Collins was on CBS' "Face the Nation" and CNN's "State of the Union," Graham 
appeared on ABC's "This Week" and Paul was on NBC's "Meet the Press," and Short 
was on CBS, NBC and "Fox News Sunday."


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