Vice President Mike Pence took to the local airwaves Tuesday in a last-gasp effort to increase pressure on Sen. Susan Collins of Maine, expressing his disappointment with her opposition to Republican efforts to repeal the Affordable Care Act. A few hours after Pence took Collins to task, Republican leaders in the Senate announced they were throwing in the towel and would not hold a vote on the legislation for lack of support.

“We are certainly disappointed that Sen. Collins has chosen to vote against the Graham-Cassidy bill,” Pence told WGAN talk radio hosts Matt Gagnon and Ken Altshuler during a call-in Tuesday morning.

Collins announced Monday that she wouldn’t support the latest effort by fellow Republicans to dismantle former President Barack Obama’s landmark health care law. She said that the Graham-Cassidy bill, named for Republican co-sponsors Sens. Lindsay Graham of South Carolina and Bill Cassidy of Louisiana, went too far. Collins said the measure would strip health care coverage from thousands of Mainers, especially those on Medicaid. The disabled, children and low-income seniors make up most of the 265,000 people in Maine who have Medicaid, which is funded with a blend of federal and state money.

“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.” Collins said in a written statement.

Collins’ decision was pivotal, as she joined at least three other Republicans, including Sen. John McCain, R-Arizona, in opposing the bill, which needed at least 50 votes to move it back to the House of Representatives. It only takes three Republican defections to derail efforts to repeal the ACA in a Senate where Republicans hold a slim 52-48 majority.

Collins, McCain and Sen. Lisa Murkowski, R-Alaska, all have voiced their opposition to varying incarnations of ACA repeal bills because of the impacts on Medicaid or for lack of “regular order” – the normal process of making law that includes public hearings with testimony on a bill’s impact presented to lawmakers ahead of any votes.

Pence, however, took aim at the ACA, saying in 2015 more than 34,000 Mainers decided to pay the tax penalty for not having health insurance under the federal law rather than purchasing federally subsidized plans on the federal exchange.

“This is the best opportunity that we have had to give the people of Maine, to give the people of America, a fresh start on the failing policies of Obamacare,” Pence said. He later said the Graham-Cassidy bill presented a uniquely “American” solution and vowed he and President Trump would not give up on their efforts to repeal and replace the ACA, which failed for the third time Tuesday.

“We are going to get this done whether it is this week or some time in the days ahead because Obamacare is going to continue to collapse, the American people are hurting and President Trump and I are going to continue to work our hearts out to give the American people a fresh start on health care reform that, again, is built on the power of the free marketplace and an individual free-market choice and a state-based reform,” Pence said.

Annie Clark, Collins’ spokeswoman, said the senator has spoken with Pence numerous times in recent months on health care reform. The two spoke as recently as last weekend, “when (Collins) underscored her specific concerns with the Graham-Cassidy proposal, including: the sweeping Medicaid cuts; the weakening of protections for people with pre-existing conditions; and the widespread agreement between physicians, patient advocates, insurers and hospitals that this legislation would lead to higher premiums and reduced coverage for tens of millions of Americans,” Clark said.

As Indiana’s governor, Pence expanded Medicaid in his state under the ACA, but got waivers from the Obama administration to implement plans that kick healthy people off the program for six months if they fail to pay premiums.

Pence referenced those waivers during his call-in to the Portland radio show Tuesday, saying provisions in the repeal bill would send states their federal Medicaid share in the form of block grants.

“The really exciting thing about Medicaid in the Graham-Cassidy bill is that by block-granting resources back to the state, states like Maine will be able to innovate and create new programs, a bit of which we did when I was governor of the state of Indiana,” Pence said. “I got a small amount of flexibility from the last administration and we were able to introduce health savings accounts, we were able to get people out of emergency room care and into primary care. Some of our most under-privileged Hoosiers were able, for the first time in their lives, to choose their own doctor and engage in wellness practices that were incentivized in the programs.”

Tuesday’s appearance by Pence was the second time in two weeks that he has singled out Collins. Last week, the vice president and Maine Gov. Paul LePage – a Republican who has publicly urged Collins to support the party’s repeal bills – attempted to pressure her during a news conference in Washington, D.C.

President Trump also expressed his disappointment Tuesday with the Senate Republicans who had opposed the bill, calling the lawmakers, whom he did not mention by name, “so-called Republicans.”

Collins said her opposition is centered in part on projections from independent and non-partisan health care analysts that show the bill would lead to the loss of more than $1 trillion in federal funding for Medicaid between 2020 and 2036. Under the bill, Maine would lose $1 billion in federal funding through 2026 and another $17 billion through 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,” Collins said.

In a statement to the Press Herald on Tuesday, Collins said the path forward for reforming the ACA rests in a series of bipartisan bills that are currently being developed by the Senate Health, Education, Labor and Pensions Committee, which Collins sits on.

“We should avoid repeating the mistakes of 2009, when the ACA was rammed through without a single Republican vote and without a focus on the root causes of escalating health care costs,” Collins said. “Bipartisan solutions to repair the problems in the ACA are possible.”

She also pointed to two bills she has sponsored, including one that redefines full-time work under the ACA because the current definition has resulted in reduced hours and pay for workers, while the other would provide federal “seed money” to help states establish what are known as “invisible” and traditional high-risk reinsurance pools that have shown to be effective at lowering premiums.

“My focus will remain on improving our health care system and increasing access to affordable health care,” Collins said. “Democrats must come to the table so that we can work together to advance a series of bipartisan bills that will make much-needed improvements in our health care system.”

Last week, Collins rolled out one of the bills, co-sponsored by Sen. Bill Nelson, D-Florida, that provides $2.25 billion per year in federal funding for state-run reinsurance programs.

Scott Thistle can be contacted at 791-6330 or at:

sthistle@pressherald.com

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