(Bloomberg)—Senator Susan Collins punctured any remaining GOP hopes of repealing Obamacare anytime soon, dealing a fatal blow by rejecting a last-gasp Republican healthcare bill.

The Maine Republican became the third GOP senator to oppose the measure, issuing a blistering statement signaling she had never been close to backing it.

“It makes sweeping cuts and changes in the Medicaid program, which is a vital program for our low-income, vulnerable citizens, including disabled children and low-income seniors,” she told reporters Monday evening, adding that President Donald Trump and senior members of his administration had tried to woo her over the weekend.

Her “no” marks the latest failure by Republicans to deliver on their promises to repeal the law, which they campaigned on for seven years and have tried to push through Congress for the past nine months. Republicans face a September 30 deadline to adopt a repeal measure under a fast-track mechanism that allowed them to pass a bill and bypass Democratic support.

The result also puts Republicans in the position of having to decide whether to engage in bipartisan talks with Democrats to fix a healthcare law they’ve spent years attacking or potentially letting it fail over time and risking the blame.

Majority Leader Mitch McConnell still has to decide whether to hold a formal vote or simply pull the bill. But it became clear late Monday that a series of last-minute revisions by bill authors Lindsey Graham of South Carolina and Bill Cassidy of Louisiana weren’t enough to change the outcome.

Collins, whose support was long in doubt, made clear that some of the changes, which would have funneled more money to her home state of Maine, made it even harder for her to support the measure.

“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 said in a statement. “This is simply not the way that we should be approaching an important and complex issue.” Collins also criticized the rushed pace of drafting the bill, as well as its cuts to Medicaid and lack of protections for some sick people.

Her opposition made her the third “no” among Republicans, after Senators Rand Paul of Kentucky and John McCain of Arizona earlier said they too would vote against the bill. Republicans have 52 votes in the chamber, and can only afford to lose two of their members.

Republicans, who control both houses of Congress, now have few options—none of them likely to meet their campaign-season promises to repeal the Affordable Care Act entirely.

They can try to repeal it again later by pairing a proposal with a tax-overhaul package, although doing so could imperil both goals. They can let the existing law and its insurance markets descend into turmoil, as the Trump administration has threatened. Or they can return to bipartisan talks over a small package of fixes, as Democrats have urged.

Democratic Senator Patty Murray of Washington, who until last week had been working on a limited package of bipartisan fixes with Senator Lamar Alexander, said getting the two parties working together again was “the right thing to do.” She said a legislative fix “has to be dealt with very quickly” to prevent healthcare costs from rising.

“The sooner we get at it, the better. Every day, every hour counts. I’m ready to go,” said Murray. She and Alexander, of Tennessee, are the top members of their respective parties on the Senate Health, Education, Labor and Pensions committee.

Collins backed that approach.

“It’s time for Democrats to step up” Collins said. “Our focus should be on repairing the many flaws in the” Affordable Care Act.

Just before Collins’s announcement, the Congressional Budget Office issued its analysis of an earlier draft of the bill, saying that the legislation would result in “millions” fewer people with health insurance.

“The number of people with comprehensive health insurance that covers high-cost medical events would be reduced by millions compared with the baseline projections for each year during the decade,” CBO said.

The agency said Monday it didn’t have enough time for a full analysis of the legislation, which could take weeks. It did predict market “disruptions and other implementation problems would accompany the transition” to a new system of federal grants created by the legislation, partly because states would only have two years to make the changes.

The GOP bill was the latest effort by Republicans to put forward a repeal effort, after another piece of legislation put forward by McConnell was brought down this summer by a single vote.

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