Updated on September 25 at 6:32 p.m. ET
There remains a slim possibility that in the next few days, Senate Republicans will pass the health-care proposal known as Graham-Cassidy, the legislation that party leaders have described as their “last, best chance” to substantially repeal the Affordable Care Act.
But for that to happen, the bill’s champions would have to win back the vote of at least one of the three Republicans who have signaled their opposition. They’d have to persuade multiple others to abandon their previously stated positions on the sanctity of protections for people with preexisting conditions. And they’d have to lock down still more Republicans who balked on Monday at changes to the legislation that were made expressly to secure their support.
Until Monday evening, Republicans seemed to have at least a chance at pushing the measure through. But the repeal effort may have died altogether when Senator Susan Collins of Maine became the third—and for now, decisive—Republican to come out firmly against the Graham-Cassidy plan. Collins joined Senators John McCain of Arizona and Rand Paul of Kentucky in opposing the bill, with several others wavering. With unified Democratic opposition, Republicans can lose no more than two on their side and still have Vice President Mike Pence cast the tie-breaking vote to pass it. Collins formalized her position in a lengthy and highly critical statement moments after the Congressional Budget Office released a preliminary analysis finding that the Graham-Cassidy proposal, like previous GOP plans, would result in “millions” fewer Americans having health insurance.