Sen. Susan Collins would have needed several changes to be made to President Donald Trump’s One Big Beautiful Bill Act, including boosting assistance for rural hospitals, before she would have voted to approve it, she said on Friday after marching in the Fourth of July parade in the small northern Penobscot County town of Burlington.
It was a familiar situation for Collins, who previously bucked her party by casting a high profile vote opposing a major piece of legislation affecting health care during Trump’s first term. That came shortly after she marched in Eastport’s Independence Day parade in 2017.
In that case, she helped defeat the legislation which — like this week’s megabill — would have cut Medicaid funding that rural Maine communities rely on. But unlike back then, the current piece of legislation is now on track to become law, after the House approved it Thursday and Trump was expected to sign it.
On Friday, during her first public appearance in Maine since voting against Trump’s megabill earlier in the week, Collins explained that one of her concerns was that it will cut $5.9 billion from the state’s Medicaid program, known as MaineCare, over the next decade. That will harm low-income families and Maine’s health care infrastructure, especially rural hospitals that are already struggling financially, she said.
Collins, along with Sens. Rand Paul of Kentucky and Thom Tillis of North Carolina, were the only three Senate Republicans to vote against Trump’s bill, but it passed the chamber earlier this week in a 50-50 vote with Vice President JD Vance giving the deciding vote.
Collins proposed amendments to the bill that would’ve increased relief funding for rural hospitals from $25 billion over five years to $50 billion by raising taxes on Americans earning $25 million per year, or couples making $50 million. Senators rejected Collins’ proposal, but later agreed to create the $50 billion fund.
That’s double the $25 billion allocation the bill initially included, but Collins said it still isn’t enough to compensate for Medicaid payments that are “already too low.”
“We have five [hospitals] at least that are already in very bad financial shape,” Collins said. “We’ve lost [Northern Light] Inland Hospital in Waterville in May and lost 27 nursing homes in the past nine years.”
The loss of funding to hospitals, nursing homes and other health care resources could be especially devastating in Maine, which has the oldest median age in the country.
There were also issues with the way funding for the Supplemental Nutrition Assistance Program, or SNAP, was calculated in the bill, Collins said. Specifically, she opposed how people receiving low-income heating assistance payments were going to have those payments counted toward their eligibility for food stamps.
“Although seniors and disabled individuals were exempted from that, a low-income mother with three children who was receiving [heating assistance] payments could see her food stamp allotment either decline or taken away altogether,” Collins said.
Collins said she discussed these changes with “the White House and Republican leadership,” but did not specify who she spoke with or give details on how those conversations went.
Collins offered these comments after marching in the Burlington/Lowell Fourth of July parade on Friday morning, which drew a crowd of several hundred.
Walking among trucks and all-terrain vehicles down Long Ridge Road in Burlington, she greeted those lined along the parade route. Many spectators cheered or thanked Collins for her work, while a few whispered questions to their neighbor about who she was.
It was relatively friendly terrain for the moderate Republican. Trump easily won both Lowell and Burlington in the 2024 presidential election. Nearly 200 Lowell residents voted for Trump while 68 voted for Kamala Harris. In Burlington, Trump earned 185 votes over Harris’ 59.
While it would’ve taken several changes for Collins to support the bill, she said that she approved of some pieces of it, such as extending the tax reductions first passed in 2017 that helped small businesses as well as low and middle-income families.
She also voiced support for work requirements for able-bodied adults, with exemptions for those going to school, caring for young children or acting as a caregiver for an ill or disabled parent or spouse.
“I wish the bills had been separated so that I could’ve expressed my support for most of the tax provisions in the bill,” Collins said.
