Sen. Susan Collins, R-Maine, and Sen. Joe Manchin, D-W.Va., right, discuss the bipartisan immigration deal they reached during a news conference at the Capitol in Washington, Thursday, Feb. 15, 2018. Credit: J. Scott Applewhite | AP

AUGUSTA, Maine — Health care changes pushed by U.S. Sen. Susan Collins of Maine were left out of an omnibus budget deal that is tracking for passage by a Friday deadline, leaving her blaming a top Republican for not including them amid Democratic opposition.

The political blow came on a whipsaw Wednesday for Collins, a moderate Republican who has pushed for changes aimed at stabilizing the Affordable Care Act since she agreed to support a Republican tax bill in December after promises from top Republicans that her proposals would get a vote.

[Collins health proposal left out of $1.3 trillion budget deal]

At first, Collins wanted those changes to pass alongside the tax bill to offset the repeal of a requirement that Americans have health insurance or face a penalty, but they were left out. She then said they would be considered early this year and called the budget bill “the last opportunity” to stabilize the health care market and prevent premium increases.

But a lot has changed since December — both politically and in the policy arena. The bill broke down amid a partisan fight around abortion language and premium increases in the health care market that accounted for some of the changes in the tax bill.

These changes began as a bipartisan proposal, but Democrats now oppose it, with their main concern revolving around language that would expand a ban on federal funding for abortion coverage to a new funding pool in the individual market.

Collins — who supports abortion rights — and other Republicans vented over that during a Wednesday news conference and during Thursday speeches on the Senate floor. The Maine senator called Democrats’ argument “phony” because language banning federal funding for abortion is standard in federal law.

But there is also a wonkier reason that it is languishing: The nonpartisan Congressional Budget Office released a letter earlier this week saying that funding the subsidies would lead to 500,000 more people being uninsured in 2019 because of changes made by states and insurers.

Republicans said Wednesday that President Donald Trump, House Speaker Paul Ryan, R-Wisconsin, and Senate Majority Leader Mitch McConnell, R-Kentucky, were on board. But by day’s end, Collins hit Ryan on Twitter for not including her favored changes in the House version of the budget bill because of opposition from House Minority Leader Nancy Pelosi, D-California.

[Critics say Collins’ bill to stabilize insurance market would restrict abortion coverage]

Collins called it “extremely disappointing.” Democrats are now using it to bolster past arguments that Collins’ original tax vote was based on a bad deal.

During her floor speech Thursday afternoon, Collins urged senators to insert the proposals into the budget bill, calling it “urgent.” She suggested that opposition was based on misunderstanding or misinformation and predicted that, without implementation of her proposal, insurance rates in the private market would “skyrocket” in the fall.

Larry Levitt, the senior vice president for health care reform at the Kaiser Family Foundation, said “the insurance market is stable” without the Collins-backed bill, though insurance premiums in the market will rise. That will be the issue between now and the November election.

“The midterm election is looming over this,” he said. “What we’ll see is a huge spin battle in the run-up to the election over who’s to blame for higher premiums.”

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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...