Sen. Collins: Health Care Bill Would Make Changes to Medicaid Without Senate Having 'a Single Hearing to Evaluate Their Impact'

By Melanie Arter | July 17, 2017 | 10:38 AM EDT

Sen. Susan Collins (R-Maine) (Screenshot of ABC video)

( – Sen. Susan Collins (R-Maine) complained Sunday that the Senate health care bill would make changes to Medicaid without have a hearing on the possible impact of those changes.

“This bill would make sweeping and deep cuts to the Medicaid program, which has been a safety net program on the books for more than 50 years, ensuring that some of our most vulnerable citizens, our disabled children, our low-income seniors, receive the health care that they need,” Collins told ABC’s “This Week.”


“It would also jeopardize the very existence of our rural hospitals and our nursing homes, which not only provide essential care to people in rural America, but also are major employers in the small communities in which they are located,” she said. “And worst of all, these changes would be made without the Senate having held a single hearing to evaluate their impact.”

Collins said she disagrees with Vice President Mike Pence that the Better Care Act would provide for the most vulnerable, improve Medicaid, and lead to better outcome.

Voting on the bill has been delayed until Sen. John McCain (R-Ariz.) recovers from surgery for a blood clot.

When asked whether Senate Majority Leader Mitch McConnell (R-Ky.) has the votes to get the bill passed, Collins said, “I don’t know. I think it would be extremely close. There are many of us who have concerns about the bill, particularly the cuts to the Medicaid program, but there are other problems with the bill as well.

“It could lead to insurance plans that really are barely insurance at all. It would cause premiums to increase for some very vulnerable individuals, including those with preexisting conditions, depending on what states decide to do, so there are a lot of us who have concerns about the bill,” she said.

“On the Senate side, I would estimate that there about eight to 10 Republicans senators who have deep concerns, but how this would all translate out I’m not certain, and I never underestimate Leader McConnell’s skills,” Collins said.

“But if you look at Medicaid, which you’ve mentioned repeatedly on this, isn’t Medicaid spending now out of control? If you look at the estimates, Medicaid is estimated to be at nearly a trillion dollars a year by 2025. That’s a 70 percent increase in Medicaid spending over the course of a decade. You heard the vice president. He says that this bill puts Medicaid on a more sustainable path. You’d acknowledge right now it’s not a sustainable path?” ABC’s Jonathan Karl asked.

“I would never say that the Medicaid program should not be scrutinized to see if we can lower the costs. I believe there’s a good model in Indiana, which applied a managed care approach to the expansion of Medicaid that was done in that state under the Affordable Care Act,” Collins said.

“That offers some very useful models that I believe could be replicated in other states, but to totally change the program and to set a future insurance as future inflation rate, that we know will not cover the costs of medical care at a time when the Baby Boomer generation is going to be needing those services, it’s not the way we should proceed,” she said.

“Should we proceed, have careful hearings and look at what we can do to make sure that the Medicaid program can continue to be there for future generations without bankrupting the federal budget? Absolutely, but we haven’t had that kind of in-depth analysis, public hearings of that, all kinds of ideas that would be useful in lowering costs of the program and producing better outcomes, which is what the Indiana model has done,” Collins added.

Collins said she’s been in touch with members of the Trump administration about the bill, which she calls “a work in progress.”

“Let me make clear, I think there are substantial flaws in the Affordable Care Act. It has produced premium increases that are very troubling and difficult for people to afford, particularly those who don’t get the subsidies under the current law, and in some counties in some states, the markets are literally collapsing, so that even if you have a subsidy, you’re not going to find that there’s an insurance policy that you can purchase,” Collins said.

Collins said it would be a mistake to pass the Senate health care bill “without a single Democratic vote.”

“So we do need to fix the significant flaws in the current law, but the way to do that is through the normal process of committee hearings and expert witnesses and writing a bill with bipartisan support. President Obama in my view made a serious mistake when he pushed through the Affordable Care Act without a single Republican vote. I don’t want to make the same mistake in reverse and push through this bill without a single Democratic vote,” she said.