GOP Health Care Bill Appears Dead After Sen. Collins Declares Opposition

The latest effort to repeal the Affordable Care Act appears to be blocked after Maine Sen. Susan Collins opposed the bill. Her opposition means the bill cannot pass the Senate with only GOP support.

AILSA CHANG, HOST:

The latest Republican effort to repeal the Affordable Care Act appears all but dead tonight now that Republican Senator Susan Collins of Maine says she does not support the proposal. She joins Republican senators John McCain and Rand Paul in opposing the bill, and that is one too many noes for the bill to pass the Senate with only Republican support. Collins' announcement comes minutes after the Congressional Budget Office said the plan known as Graham-Cassidy would leave millions more people without health insurance coverage. And all this caps a dramatic day of hearings and protests on Capitol Hill.

Joining us now to talk about the day is NPR health policy correspondent Alison Kodjak. Hi, Alison.

ALISON KODJAK, BYLINE: Hi, Ailsa.

CHANG: So why does Senator Collins say she's opposed to this plan?

KODJAK: Well, Senator Collins says, you know, she's worried about the cuts to the Medicaid program. This plan would roll back the expansion of Medicaid that happened under the Affordable Care Act, and it would grow the program more slowly over time. Now, Medicaid covers the poor, low-income people and people with disabilities. And, you know, it's very hard to see how they can grow it more slowly than inflation and still cover those people.

She also says she's worried about people with pre-existing conditions. This bill doesn't actually have the same level of protection as the current law. And, you know, if it were to go into effect, insurers potentially in some states could charge people more if they have a pre-existing condition. And it could eliminate some types of coverage like mental health care or maternity care, which then wouldn't give people who need those coverages the care they need.

CHANG: Senator Collins' decision came on the heels of this Congressional Budget Office analysis. What did the CBO say about this proposal?

KODJAK: Yeah. You know, it was interesting. The CBO was only supposed to talk about the deficit impact of this bill. And it did say that it would reduce the deficit by $133 billion. But the CBO decided to go further. It said that while it didn't have time to do its thorough analysis, it concluded that millions fewer people would have insurance under this plan. It said that a lot of people would lose coverage because of that Medicaid rollback and that who lost insurance would really depend on what state they lived in. And that's because this bill would have taken all this money from the Affordable Care Act and instead redistribute it to states to design their whole - their own health plans.

CHANG: Right.

KODJAK: And it was unclear what each state would do.

CHANG: So that report comes on this day where there was a lot of drama on Capitol Hill, right? What happened?

KODJAK: Yeah, there were protests. And they were pretty dramatic on Capitol Hill.

CHANG: Yeah.

KODJAK: There was a hearing in the Senate, the Senate Finance Committee, which is going to be the only hearing on this bill. And early in the day, a lot of advocates for people with disabilities showed up. And they were determined to fill that hearing room. And a lot of them were in wheelchairs. And as soon as the hearing opened, they started chanting. And they were chanting, no cuts to Medicaid, save our liberty. The senators couldn't speak over them. They couldn't proceed. And it delayed the hearing. And eventually, the Capitol police were called in. And they had to drag people out of the room. They took some out of their wheelchairs. They wheeled them out in their wheelchairs.

CHANG: Wow.

KODJAK: It really made for some unsettling images.

CHANG: So now that at least three senators, Republican senators, are opposing this bill, I suppose now Senate Majority Leader Mitch McConnell has a decision to make, right?

KODJAK: Yeah. He has to decide whether or not to pull this bill or to take it to a vote. And, you know, it's unclear what he'll do. If at some point he does pull it or the bill fails, there is a bipartisan effort standing in the wings, waiting to go forward. And so we'll see what happens, whether that can get done after this bill finally disappears.

CHANG: All right. Alison Kodjak is NPR's health policy correspondent. Thank you, Alison.

KODJAK: Thank you, Ailsa.

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