“Health care is a deeply personal, complex issue that affects every single one of us and one-sixth of the American economy,” Ms. Collins said in a statement, lamenting the rushed process and the content of legislation that has shifted as Republican leaders scrambled for votes. “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.”
The Senate majority leader, Mitch McConnell of Kentucky, now faces the unpalatable choice of admitting defeat or moving ahead with a vote that appears certain to fail.
Republican leaders in the Senate can afford to lose only two of their members, and they now have three firm opponents within their ranks: Rand Paul of Kentucky, John McCain of Arizona and Ms. Collins. Additionally, Senator Ted Cruz, Republican of Texas, has withheld his support and requested changes to the bill.
Time is not on their side: Republicans have only until the end of the month to pass the bill through the Senate while being protected from a Democratic filibuster.
Beginning in October, Republicans would need Democratic votes in order to pass a repeal bill, a seeming impossibility given that Democratic senators have been unified in opposition to the repeal push.
Some Republican senators have suggested starting over, with parliamentary language in a new budget blueprint that once again would shield repeal legislation from a filibuster. But that could terribly complicate Republican efforts to overhaul the tax code, a risk the leadership may not want to take.
Ms. Collins’s announcement came three days after Mr. McCain said that he could not “in good conscience” support the latest repeal proposal, written by Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana.