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U.S. Sen. Susan Collins’ vote remains up in the air on President Donald Trump’s massive tax and spending bill after the Senate overwhelmingly shot down her attempt to double a proposed relief fund for rural hospitals.
Her effort was among a ream of amendments that were shot down during an all-night session from Monday into Tuesday as the Republican-led Senate rushed to meet the president’s preferred July 4 deadline to pass the bill. But at least three senators have already indicated opposition to the One Big Beautiful Bill Act, which looks bogged down for the moment.
That placed Collins further in the spotlight and in a difficult place between her fellow Republicans and her blue state reliant on rural health care. The senator, who is a top Democratic target in the 2026 election, told reporters early Tuesday morning that her party should pass tax and health care changes in separate bills instead of one.
The key parts of the measure would extend tax cuts passed in 2017 during the president’s first term, cut spending on Medicaid and food stamps through stricter eligibility requirements and sharply increase funding for immigration enforcement. The bill’s effect on rural hospitals has been the focus of debate in Maine.
Collins attempted to address this by doubling a relief fund for rural hospitals by raising taxes on the very richest Americans. But it was shot down in a lopsided 78-22 vote. The senator blamed Democrats for voting against it by telling reporters that her measure addressed many of their criticisms of the package and amounted to “a very hypocritical approach.”
Two Republicans, Thom Tillis of North Carolina and Rand Paul of Kentucky, have come out against the bill. Leaders won over Sen. Lisa Murkowski of Alaska over the weekend with changes tailored to her state, but the Senate parliamentarian ruled that they could not be included and put her vote back in question. Republicans can only lose three members.
Murkowski voted with Collins against an attempt to strike a ban on Medicaid funding to Planned Parenthood on Monday. Notably, Collins was the only Republican to oppose withholding Medicaid funding to states that give health coverage to undocumented immigrants charged or convicted of serious crimes.
That made Collins clearly stand out from the rest of her party, but Senate Democrats’ campaign arm faulted her for voting against three other amendments offered by members of their party to undo major tax and health care cuts altogether.
