In this June 9, 2020, file photo Sen. Susan Collins, R-Maine, is followed by reporters as she arrives for the weekly Republican policy luncheon on Capitol Hill in Washington. Credit: Susan Walsh | AP

Welcome to Ad Watch, in which the Bangor Daily News’ political team breaks down who is behind political ads you’re seeing and whether what they are saying is true.

A new ad from U.S. Sen. Susan Collins features a supporter vouching for her support of maintaining health care protections for people with pre-existing conditions. While she has supported those protections, the law enshrining them is endangered by a Republican tax-cut law that she backed in 2017.

The ad

Who is behind it

The ad comes from Collins’ campaign, which raised $16.7 million through June 30. You can follow campaigns’ fundraising and spending in the U.S. Senate race with us here. The fourth-term Republican is running in a nationally targeted 2020 re-election race against Maine House Speaker Sara Gideon, D-Freeport, and independents Lisa Savage and Max Linn.

The major claims, with context

The ad features Brian Denger of Biddeford, who said in a 2019 letter to the Portland Press Herald that his relationship with Collins dates back to 2001 after his sons were diagnosed with a rare genetic condition causing severe muscular weakness. Collins co-sponsored a 2001 law that led to more funding for research into the condition.

The point of the ad is more general. Denger closes by saying Collins “has always been there for families with pre-existing conditions.” Protections for those people have become a big federal campaign issue since Republicans’ failed 2017 bids to repeal the Affordable Care Act. Collins was one of three Senate Republicans who cast deciding votes to sink repeal then.

The health care law guarantees that insurers cannot refuse to cover you or make you pay more for insurance because you have a pre-existing condition ranging from asthma to cancer. That protects 54 million people who may have been uninsurable under past individual markets, according to the Kaiser Family Foundation.

It is one of the most popular parts of the complex health care law championed by former President Barack Obama, a Democrat. It passed in 2010 with all Republicans, including Collins, opposing it. She voted repeatedly to repeal it in votes that were mostly symbolic before President Donald Trump, a Republican, took office in early 2017.

The most unpopular part of the law was a mandate that individuals have health insurance or pay a penalty. That was axed in Republicans’ late 2017 tax-cut law that Collins backed. The Trump administration has used the repeal of that tax to argue that the entire health care law is moot.

A case on that will be argued before the U.S. Supreme Court one week after Election Day. It is the main Democratic challenge to Collins on pre-existing conditions. We do not know what the court will do after upholding the health care law in 2012, but the tax law endangered it for now.

While Collins has criticized the Trump administration for not defending the protections in court, the administration’s legal argument is not new. It is similar to one made in a 2010 court case by Collins and other Republican senators before the law was in effect. Collins softened on the law once it took effect, though she has maintained it made care unaffordable for many.

The Maine senator is on the record in favor of protections for those with pre-existing conditions in other ways. In 2017, she proposed an Affordable Care Act replacement that would have maintained them while also giving states more power over health insurance programs.

Collins spokesman Kevin Kelley said the individual mandate was “harmful” to those who had to pay it and noted that another tax law provision expanded a deduction for families with high medical expenses. He said “important consumer protections for people with pre-existing conditions” remain because of the senator’s vote against repealing the health care law.

But while Trump and other Republicans have said they favor these protections, there is no consensus replacement plan if the law is tossed. The House Republican plan from 2017 was written in a way that looked to retain the protections, but experts said it could have allowed insurers to raise rates for those people in ways that would make coverage unaffordable.

This is the U.S. Senate, where many things can be true. Collins has stood up for these protections in many ways that Denger can fairly point to. But it is also fair to point to her tax vote as something that could erode them, though it is unclear what the high court will do.

Michael Shepherd joined the Bangor Daily News in 2015 after time at the Kennebec Journal. He lives in Augusta, graduated from the University of Maine in 2012 and has a master's degree from the University...