President Donald Trump’s “big, beautiful” budget bill squeaked through the House of Representatives on Thursday but now faces questions from Republican senators including Susan Collins over everything from Medicaid cuts to increasing the national debt.
The Maine senator and her colleagues have already signaled they may seek changes to the House version that is more than 1,100 pages long and that the lower chamber passed 215-214 on Thursday, sending it to the Senate for negotiations and votes before Republicans aim to get it to Trump’s desk by early July.
While reiterating she does not want to cut Medicaid, Collins has left open the possibility of supporting work requirements for certain adults in the program serving more than 70 million Americans. Yet her caucus may not need her vote to pass the massive proposal that also seeks to extend Trump’s 2017 tax cuts that Collins supported.
The Congressional Budget Office estimated 7.6 million more people would become uninsured under the Medicaid changes that would save nearly $700 billion over a decade. Roughly 400,000 Mainers are enrolled in the low-income health insurance program. Extending the tax cuts would cost more than $3 trillion over 10 years.
Collins and Sen. Rand Paul of Kentucky were the only two Republicans to vote against a budget framework in April that set the stage for the current negotiations over the bill Trump described on social media as “arguably the most significant piece of Legislation that will ever be signed in the History of our Country!”
“I cannot support proposals that would create more duress for our hospitals and providers that are already teetering on the edge of insolvency,” Collins said in a statement Friday.
But Collins did not close the door on work requirements, saying she could support them for “able-bodied men and women who are capable of working and do not have obligations that preclude them from participating in the workforce.”
Liberal advocacy groups are urging Collins to oppose any Medicaid cuts, also noting the House version would bar Planned Parenthood, the nation’s largest abortion provider, from receiving Medicaid funds. But Collins may not end up as the key vote on the budget bill. Her vote may instead carry more significance in 2026, when she is up for reelection for a sixth term.
Kyle Kondik, managing editor of election forecaster Sabato’s Crystal Ball at the University of Virginia’s Center for Politics, said Collins and U.S. Thom Tillis, R-North Carolina, may “get a pass to vote no” on the final version of the budget bill if all other GOP senators back it.
“Collins probably has the most leeway to vote the way she pleases on this bill, because Republicans do not need her support to pass it in the Senate,” Kondik said, noting Collins is the only Republican senator from a state that Trump lost in 2024.
Collins’ office also noted the budget reconciliation negotiations are largely not happening through the Senate Appropriations Committee she chairs, as that panel handles discretionary spending while the reconciliation process deals with “mandatory” spending.
U.S. Reps. Chellie Pingree and Jared Golden, both Democrats, voted against the House budget bill Thursday, with each of them criticizing the plan’s cuts to Medicaid, Affordable Care Act tax credits and food stamp benefits. The Maine Republican Party criticized them in a Friday fundraising email for saying they “abandoned the Maine people’s needs.”
U.S. Sen. Angus King, an independent who caucuses with Democrats, was traveling and unable to comment Friday, but his office pointed to his comments this month to Democratic strategist James Carville in which King said Medicaid cuts would be “catastrophic.”
“I’ve never understood why there are certain people in this country that seem hellbent to take health insurance away from people,” King said. “I just don’t get it.”
