AUGUSTA, Maine — Sen. Susan Collins, R-Maine, announced her opposition on Monday to the Graham-Cassidy bill, a move that could doom the latest Republican effort to repeal the Affordable Care Act.

In a statement, Collins said the bill contained “devastating” Medicaid cuts and could weaken protections for people with pre-existing conditions. She also criticized Maine-centric changes to the bill that emerged Sunday as a “give with one hand, take with the other” model.

“This is simply not the way that we should be approaching an important and complex issue that must be handled thoughtfully and fairly for all Americans,” she said.

Collins formally disclosed her decision a day after the bill’s sponsors made the package more favorable to Maine relative to an earlier version in order to try to secure her vote. But her final decision was no surprise, since she said last week that she was “leaning against” the bill.

It may sound the death knell for the legislation already opposed by two other Republicans — Sens. John McCain of Arizona and Rand Paul of Kentucky — in a chamber their party controls by a 52-to-48 margin.

Democratic senators and the two independents who align with them — including Sen. Angus King of Maine — are united in their opposition. Collins was one of three Republicans who in July killed the party’s last bid to repeal the health care law informally known as Obamacare.

The current bill — sponsored by Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana — would eliminate Affordable Care Act exchange subsidies and a higher reimbursement rate for Medicaid expansion states and replace them with lower block grants.

Supporters have touted the bill as a flexible alternative to past repeal proposals, but an analysis last week from the Kaiser Family Foundation said that from 2020 to 2026 it would amount to a $160 billion cut in federal health care funding.

On Sunday, Graham-Cassidy backers circulated a list of revisions that would redirect additional money to Maine and to Alaska — the home of Republican Sen. Lisa Murkowski, who voted with Collins and McCain against repeal in July.

On Monday, Cassidy told The Washington Post that he hoped the extra money “would make a difference to Collins.” But she told the Post after her vote that President Donald Trump called to lobby her on Monday and she replied that she was “not likely to be a yes.”

The revisions indicated that Maine would gain 43 percent more federal funding than under Obamacare. However, they didn’t appear to take into account a proposed per-enrollee cap on Medicaid funding.

The Kaiser analysis said that would lead to an overall cut in Maine’s funding, and in her statement Collins said 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.”

The move may affect Collins’ political future: She is expected to announce before the end of October whether she’s going to run to succeed Gov. Paul LePage. After Collins’ July vote against repeal, LePage told supporters at a party event that Collins would “back down” from running for governor if the Republican base rejected her.

LePage was with Vice President Mike Pence on Friday urging senators to pass the Graham-Cassidy bill. Pence will appear on Portland radio station WGAN on Tuesday morning.

Michael Shepherd

Michael Shepherd joined the Bangor Daily News in 2015 after three years as a reporter at the Kennebec Journal. A Hallowell native who now lives in Augusta, he graduated from the University of Maine in...