Sen. Susan Collins (R-ME) just became the fourth Republican to oppose the GOP’s last-ditch effort to repeal and replace the Affordable Care Act.

Collins had been on the fence prior to the Congressional Budget Office’s scoring of the bill Monday evening, which seemed to drive her over the edge.

“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,” Collins wrote in her statement announcing her opposition to the bill.

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Read Collins’ entire statement below.