U.S. Sen. Susan Collins said Tuesday that despite Senate Republicans’ failure to advance replacement of the Affordable Care Act, the path toward a better health care plan has clarified.

Collins said moving development of the bill from “behind closed doors” to the public process — through a Senate committee Collins is a member of — is a change of course she welcomes.

“It’s much better to have public hearings and to hear from witnesses,” said Collins, a member of the Senate Health, Education, Labor and Pensions Committee, which is where the hearings will begin. “I’ll be playing a major role in that process.”

After the Senate’s latest effort to repeal and replace the Affordable Care Act stalled last week amid opposition from Collins and a group of conservative and moderate Republicans, Senate Majority Leader Mitch McConnell, R-Kentucky, announced a plan to simply repeal the health care law.

But that ran into a similar math problem on Tuesday, when Collins and two other moderate Republican senators doomed the repeal-only plan by vowing to block it.

Tuesday afternoon, the chairman of the Senate health care committee said he would convene hearings on “how to stabilize the individual market” after a health care vote in the chamber. Collins recommended that course of action on Tuesday. She said it’s a chance to address some of the “very serious flaws” in the Affordable Care Act that have insurance companies pulling out of some states and people across the country still unable to find a plan they qualify for and can afford.

“The fact the health insurance markets are so unstable is an indication of flaws in the law,” said Collins. “They need to be corrected and that will be one of the focuses I have.”

Among the specific changes Collins has advocated for throughout the debate are implementing a phase-in system for the subsidies that avoids people losing coverage because they go over certain income thresholds, known as going over a financial cliff. She also wants a “full time employee” redefined from 30 hours a week, as it is in current health care law, to 40 hours a week.

“Those cliffs that are in Obamacare are not good policy,” she said. “Not only do they impose a hardship on people who have incomes that vary from year to year, but also they discourage working extra hours, discourage accepting a promotion, and discourage accepting a pay raise because it may jeopardize your entire subsidy.”

But perhaps the biggest problem for Collins is the deep cuts to Medicaid that were proposed in the failed Senate bill. She said Maine nursing homes rely on Medicaid for up to 70 percent of revenue and that deep Medicaid cuts could drive them out of existence. She said during an Independence Day event in Greenville, she heard from constituents who feared for the 180 jobs at Charles A. Dean Memorial Hospital.

“Were it to be forced to shut its doors it would be taking 180 good-paying jobs out of that community and it would deliver a devastating blow both from an economic perspective and a health care perspective,” said Collins. “That’s why I want to fix the egregious flaws in the law but not throw the baby out with the bathwater.”

U.S. Sen. Angus King, a Maine independent who caucuses with Democrats, also called for both parties to “work together to improve the health care system” in a Facebook video on Tuesday.

A spokesman for King confirmed that he has been asked by Sen. Joe Manchin, D-West Virginia, to join an informal, bipartisan group of former governors in the Senate that The Daily Beast reported Tuesday could meet as early as this week to discuss potential health care solutions.

BDN writer Michael Shepherd contributed to this report.

Christopher Cousins

Christopher Cousins has worked as a journalist in Maine for more than 15 years and covered state government for numerous media organizations before joining the Bangor Daily News in 2009.