WASHINGTON — The last-gasp Republican drive to repeal former president Obama’s health care law essentially died Monday as Senator Susan Collins of Maine joined a small but decisive cluster of GOP senators in opposing the push.
The moderate Republican said the legislation would make ‘‘devastating’’ cuts in the Medicaid program for poor and disabled people, drive up premiums for millions, and weaken protections Obama’s law gives people with preexisting medical conditions.
Collins told reporters that she made her decision despite receiving a phone call from President Trump, who has been futilely trying to press GOP senators to back the measure.
She said the legislation is ‘‘deeply flawed,’’ despite several changes its sponsors have made to round up support.
The collapse of the legislation marks a replay of the embarrassing loss Trump and party leaders suffered in July, when the Senate rejected three attempts to pass legislation erasing the 2010 statute. The GOP has made promises to scrap the law a high-profile campaign vow for years.
With their narrow 52-to-48 majority and solid Democratic opposition, three GOP ‘‘no’’ votes would doom the bill. GOP Senators John McCain of Arizona, Rand Paul of Kentucky, and Ted Cruz of Texas have said they oppose the measure, though Cruz aides said he was seeking changes that would let him vote yes.
The only way Republicans could revive the bill would be to change opposing senators’ minds, something they've been trying unsuccessfully to do for months.
The Senate must vote this week for Republicans to have any chance of prevailing with their narrow margin. Next Sunday, protections expire against a Democratic filibuster, bill-killing delays that Republicans lack the votes to overcome.
Collins’s statement came after Senate Republicans aired the details of the latest effort to undo the Affordable Care Act at a raucous hearing before the Finance Committee on Monday.
Republican Senators Bill Cassidy of Louisiana and Lindsey Graham of South Carolina rewrote the bill to deliver more money to Alaska and Maine than an earlier version.
The changes were aimed at winning over two GOP senators in those states — Collins and Lisa Murkowski of Alaska.
Also Monday, the Congressional Budget Office said the new bill would reduce insurance coverage for millions of Americans.
A contentious debate erupted Monday as protesters chanted so loudly at the hearing’s outset that the Finance Committee chairman, Orrin Hatch, Republican of Utah, temporarily adjourned as police arrested and removed several of them.
Police carried some protesters out of the hearing room and rolled out others in wheelchairs. ‘‘No cuts to Medicaid! Save our liberty!’’ screamed one woman in a wheelchair as she was wheeled out.
After a brief recess, Hatch resumed the session, but warned the audience that if their behavior got out of hand, ‘‘I won’t hesitate to adjourn.’’ He added that the situation had not yet reached that point, ‘‘but it’s close.’’
Senator Ron Wyden of Oregon, the top Democrat on the panel, questioned why Republicans were rushing to pass a measure this week that was just having its first hearing, and that he considered ‘‘a lemon.’’
After listening to Graham’s opening remarks from his seat on a far end of the dais, Cassidy took his seat at the witness table at the center of the room and told his colleagues he pushed ahead with a GOP-only bill after years of trying to work with Democrats.
‘‘So when I ask people, ‘Will you help me?’ — three years I’ve been doing this, and for three years I’ve was basically told, ‘Nice try,’ ’’ he said.
The Cassidy-Graham legislation would overhaul the Affordable Care Act by lumping together the current law’s spending on insurance subsidies and expanded Medicaid and redistributing it to states in the form of block grants.
Alaska would get 3 percent more funding between 2020 and 2026 than under current law, and Maine would get 43 percent more funding during that period under the new bill.
Read: Collins’ full statement
“Health care is a deeply personal, complex issue that affects every single one of us and one-sixth of the American economy. Sweeping reforms to our health care system and to Medicaid can’t be done well in a compressed time frame, especially when the actual bill is a moving target. Today, we find out that there is now a fourth version of the Graham-Cassidy proposal, which is as deeply flawed as the previous iterations. The fact that a new version of this bill was released the very week we are supposed to vote compounds the problem.
“I have three major concerns with both the proposal that we were discussing last week and the newest version that was put together this weekend:
“First, both proposals make sweeping changes and cuts in the Medicaid program. Expert projections show that more than $1 trillion would be taken out of the Medicaid program between the years 2020 and 2036. This would have a devastating impact to a program that has been on the books for 50 years and provides health care to our most vulnerable citizens, including disabled children and low-income seniors.
“Second, both bills open the door for states to weaken protections for people with pre-existing conditions, such as asthma, cancer, heart disease, arthritis, and diabetes. Some states could allow higher premiums for individuals with pre-existing conditions, potentially making their insurance unaffordable. States could also limit specific categories of benefits for Affordable Care Act policies, such as eliminating coverage for mental health or substance abuse treatment.
“Third, physicians, patient advocates, insurers, and hospitals agree that both versions of this legislation would lead to higher premiums and reduced coverage for tens of millions of Americans.
“The CBO’s analysis on the earlier version of the bill, incomplete though it is due to time constraints, confirms that this bill will have a substantially negative impact on the number of people covered by insurance.
“There has been some discussion that the new version of the bill includes additional money for my home state of Maine. The fact is, Maine still loses money under whichever version of the Graham-Cassidy bill we consider because the bills use what could be described as a “give with one hand, take with the other” distribution model. Huge Medicaid cuts down the road more than offset any short-term influx of money. But even more important, 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. 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.
“The Affordable Care Act has many flaws that need to be addressed. The current state of health insurance, where premiums are skyrocketing, choices are limited, and small businesses are struggling, needs fixing. My focus will remain on remedying these problems.”