Collins’ questions hint at Senate obstacles for GOP health bill

May 05--AUGUSTA, Maine -- Republicans in the U.S. House of Representatives passed their first hurdle to repealing the Affordable Care Act on Thursday. But it's going to be a different game in the Senate.

That was evidenced by the responses from Maine's two congressional Republicans: Rep. Bruce Poliquin of the 2nd District voted for the American Health Care Act on Thursday, while U.S. Sen. Susan Collins issued a list of questions indicating that she's still highly skeptical of the plan.

Thursday's vote came before the updated bill was evaluated by the Congressional Budget Office, but an earlier estimate said 24 million would lose insurance by 2026 under the plan. Overall, it said average premiums would decrease starting in 2020.

But that belies an uneven set of impacts. While premiums for younger people would go down, insurers would be able to charge more for older people.

Maine is the oldest state in the nation. Estimates from the Kaiser Family Foundation found that people just shy of Medicare age would be hard-hit by the earlier plan, particularly residents of Aroostook, Washington and Hancock counties with incomes of $50,000 or less.

The bill as written looks to maintain Affordable Care Act protections for people with pre-existing conditions, but health groups including the American Medical Association have said it would allow insurers to raise rates in a way that would make insurance unaffordable for those people. Poliquin has long said any replacement plan should cover people pre-existing conditions.

On a conference call with reporters on Thursday, Poliquin said the bill would allow people with pre-existing conditions to get insurance at the same cost as others. When pressed by a reporter on the Kaiser estimates for his district, he said lawmakers have "changed that." He also repeated the notion that "only the 7 percent of Maine residents who Obamacare health care policies" are affected by the law.

But those are oversimplifications. While an amendment to the bill added "high-risk pools" -- an idea that originated in Maine -- to cover people with pre-existing conditions, some have doubt that they'll be funded enough to tamp down costs for that population.

Also, the bill also makes wider changes to the health care system outside of the Affordable Care Act exchanges. As just one example, it would allow states to set essential health benefits via waivers, which could affect people with employer coverage.

But in a statement, Poliquin also turned to the Senate, saying he hopes the bill "comes back stronger and better." But in her own statement, Collins said "there seem to be more questions than answers" about it.

Then, she listed some of those questions, which revolved around the effect on low-income Mainers, people with pre-existing conditions as well as Medicaid and special education changes.

Collins could be a swing vote on any replacement plan and her nuanced questions indicate that this debate is going to get a lot more complicated in the upper chamber.

This item was originally published in Daily Brief, a free political newsletter distributed Monday through Friday by the Bangor Daily News to inform dialogue about Maine politics and government. To read more of today's Daily Brief, click here. To have the Daily Brief delivered daily to your inbox, click here.

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