Susan Collins opposes Graham-Cassidy, striking likely death blow to the ACA repeal bill

Sen. Susan Collins
Sen. Susan Collins says the CBO's report on the GOP's latest ACA repeal measure “confirms that this bill will have a substantially negative impact on the number of people covered by insurance.” (Shirley Li/Medill-CC BY 2.0)

Sen. Susan Collins has confirmed that she will vote against the Graham-Cassidy bill, seemingly quashing Republicans’ hopes of passing an Affordable Care Act repeal measure before the end of the month.

Collins, who also voted against a handful of other ACA repeal bills in July, said in her statement on Monday that she was not swayed by the fact that the latest iteration of the Graham-Cassidy bill included additional money for her home state of Maine.

RELATED: Graham, Cassidy offer up revised ACA repeal bill

The state will lose money anyway, she noted, because “huge Medicaid cuts down the road more than offset any short-term influx of money.”

“But even more important, 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 added.

Collins also cited the Congressional Budget Office’s preliminary analysis of an earlier version of the bill, which in her view, “confirms that this bill will have a substantially negative impact on the number of people covered by insurance.”

RELATED: Graham-Cassidy bill would result in 'millions' fewer people with health insurance, CBO says

Collins is the fourth GOP senator to come out firmly against the bill, joining Rand Paul of Kentucky, Ted Cruz of Texas and John McCain of Arizona. Other Republican senators, including Alaska’s Lisa Murkowski, remain on the fence.

GOP leaders in the Senate can only afford to lose two votes if they want to pass the Graham-Cassidy bill with a simple majority. They had planned to hold a floor vote on the measure this week, as the budget reconciliation instructions for fiscal year 2017 expire on Saturday.

In other news related to the ACA repeal bill:

More organizations join chorus of opposition to ACA repeal bill

On Monday, the CEOs of more than 15 Medicaid plans sent a letter (PDF) to Senate leaders urging them to reject the Graham-Cassidy bill, saying if it’s passed, “millions of low-income Americans, including the working poor, will be without affordable, meaningful coverage.”

The authors of the letter include executives from Molina Healthcare, Blue Shield of California, AmeriHealth Caritas and UPMC.

In a separate letter, 237 organizations also voiced their opposition, including The Leadership Conference on Civil and Human Rights, the National Health Law Program and the National Partnership for Women & Families.

“We strongly urge you to oppose the Graham-Cassidy proposal and urge Congress to instead move forward with bipartisan efforts on market stabilization and other critical issues to improve access to affordable health care for all people in the United States,” they wrote.

S&P says Graham-Cassidy will hurt economy, states, insurers

The GOP’s latest attempt to repeal and replace the ACA would result in 580,000 lost jobs and $240 billion in lost economic activity by 2027, according to a new report from the ratings agency Standard & Poor’s.

The report also predicts that the bill would increase fiscal and operational burdens on U.S. states while widening disparities among them in terms of uninsured levels.

Insurers, meanwhile, would face heightened short-term uncertainty due to the disappearance of cost-sharing reduction funding and the individual mandate, S&P says. In the longer term, the report predicts that insurers will take a “selective approach” to which states’ individual markets to participate in, depending on which rules states adopt, and vary their premium prices considerably thanks to the likely return of medical underwriting.