U.S. Sen. Susan Collins, R-Maine, predicted Monday the GOP-led Congress will face “tremendous pressure” to change President Donald Trump’s megabill of tax breaks and spending cuts if “we start seeing Americans getting sicker” as a result.
The comments from Collins, who was one of three Republican senators to vote against the bill that squeaked through Congress this summer, came during a health care forum in Massachusetts. It also served as a partial acknowledgement of the law being a vulnerability for her party as Democrats use it against Collins and other lawmakers ahead of 2026 elections.
The “One Big Beautiful Bill” extends Trump’s 2017 tax breaks, includes sizable cuts to Medicaid that Collins said total more than $900 billion, slashes food stamp programs and contains other Republican priorities, such as a rollback of clean energy initiatives and new money for deportations and national defense.
While Collins opposed the bill that the Senate passed in July thanks to a tie-breaking vote from Vice President JD Vance, she has taken flak from Democrats for voting to advance the legislation to the floor before it ultimately won approval. Collins dismissed questions in July about why she did not advance the bill by insisting “that’s not how the system works.”
As the implications of the bill become better known, Collins While speaking Monday as the featured guest at the World Medical Innovation Forum that is hosted by Mass General Brigham just outside Boston “there’s going to be tremendous pressure on Congress to change the law.”
“So if we start seeing Americans getting sicker as a result of this, having delayed treatment because they no longer have the coverage, and if it’s combined with changes in the Affordable Care Act that also would restrict coverage or make coverage more expensive to get on the exchange, then I think you will see a lot of pressure to take a better look at this,” she said.
Collins’ seat is a top Democratic target in 2026. Maine Democratic Party spokesperson Tommy Garcia criticized Collins’ remarks on the megabill at Monday’s forum by saying the senator believes “she and Congress won’t lift a finger to fix it until they see Mainers get sicker.”
Republicans are not yet totally aligned on extending the Affordable Care Act tax credits that expire at the end of this year, but Congress looks like it will agree on at least a one-year extension as part of a short-term spending deal needed to avert a shutdown by Oct. 1.
A Pew Research Center survey last month found more Americans disapprove (46%) than approve (32%) of the measure. On the Medicaid front, Collins took credit for helping to get a $50 billion rural hospital fund included in the final version of Trump’s megabill that is aimed at offsetting the Medicaid cuts in the measure.
However, she said Monday the new law and its health cuts may still cause trouble for the roughly 400,000 Mainers on Medicaid and numerous rural hospitals in the state that are “teetering on the brink of closure.”
“They go into effect the following year,” she said of the cuts. “But a year is not going to make any difference at all, and I’m just very concerned that people who need the care aren’t going to get it.”
