Maine Senator Susan Collins
Maine Senator Susan Collins
Republican Sen. Susan Collins this week unveiled her proposed amendment that aims to replace the Affordable Care Act (ACA) with a plan that will allow states to craft their own health care policies. The so-called “Patient Freedom Act” (PFA),” which Collins is co-sponsoring with Sen. Bill Cassidy (R-LA), would also scrap the requirement that everyone must buy private insurance, which helps pay for the ACA, as well as various insurance benefit mandates. 

“The Patient Freedom Act is built on the premise that giving people more choices is superior to the ‘one-size-fits-all’ approach that defined the Affordable Care Act,” said Collins in her floor remarks. “We recognize that what works best for the people of Maine or New Hampshire might not be right for the people of New York or California. Our bill respects these differences by giving states options to choose the path that works best for their citizens.”

According to Collins, the amendment would retain some of the more popular provisions in the ACA, such as prohibiting insurance carriers from putting lifetime limits on coverage and prohibiting discrimination based on pre-existing conditions. It would also prohibit carriers from denying coverage to patients and allows young adults to stay in their parents’ plan until age 26. PFA would allow states that have chosen to expand Medicaid to keep it or convert it into subsidies to purchase private insurance.

The PFA amendment would also allow states more flexibility in creating their own health care policies by providing three options. States would have the power to reimplement the ACA with all of the mandates, Medicaid dollars, cost-sharing subsidies, and benefits. States would also have the option of using federal funds for individual savings accounts, which consumers could use to pay out-of-pocket health care costs. States would also be permitted to simply go back to the pre-ACA days and develop their own programs without federal assistance. About 75,000 Mainers have coverage through the ACA.

However, Emily Brostek, executive director of Maine Consumers for Affordable Health Care, says that the proposed amendment leaves more questions than answers.



The PFA amendment would also allow states more flexibility in creating their own health care policies by providing three options. States would have the power to reimplement the ACA with all of the mandates, Medicaid dollars, cost-sharing subsidies, and benefits. States would also have the option of using federal funds for individual savings accounts, which consumers could use to pay out-of-pocket health care costs. States would also be permitted to simply go back to the pre-ACA days and develop their own programs without federal assistance. About 75,000 Mainers have coverage through the ACA.

However, Emily Brostek, executive director of Maine Consumers for Affordable Health Care, says that the proposed amendment leaves more questions than answers. 

“Opponents of the ACA have not been able to agree on what they would do to replace the ACA for the past six years. We are no closer to a replacement bill today than we were yesterday,” said Brostek in a statement. “We have seen no details on this replacement plan, and so we are left with the same key questions that must be answered for any replacement plan.”

Collins’ offices have reportedly been flooded with constituent calls in recent weeks. Repeated attempts by The Free Press to call her Augusta office on Wednesday to see if calls were getting through were met with a busy signal.

Brostek questioned whether the amendment will allow everyone who has coverage to keep their insurance; whether it will make coverage more affordable; if Mainers will be able to receive the same level of subsidies; if it will prevent women from being charged more than men for insurance; if it will require that all states continue to cover check-ups for children and mammograms and birth control without co-pays; if mental health and prescription drugs will still be covered at the same level; if it will prevent insurance companies from charging people over 55 more than they are today; if Medicaid enrollees would continue to have coverage without paying more; and if the plan would cut taxes for pharmaceutical companies and the wealthiest income earners. 

According to a recent report by the Center on Budget and Policy Priorities, repealing the ACA — thereby repealing two tax increases on the wealthy that were used to help fund the ACA   — would result in an average annual tax cut of about $7 million for 400 people whose annual incomes average more than $300 million each. 160 million households earning below $200,000 would receive nothing from the repeal of those taxes, according to the report. 

“While we await answers, the critical decision in front of all senators, including Senator Collins, is whether to support a reconciliation bill that takes insurance away from millions and raises premiums for millions more,” continued Brostek. “The Cassidy-Collins bill does nothing to prevent the chaos that will take place if this repeal is passed. The ACA should not be repealed without concrete steps to replace certain parts of the law.”

Collins has argued that the ACA has done “more harm than good,” and in early January she voted to prevent Democrats from filibustering a repeal of the ACA, which means Republicans can now repeal the law with a party-line vote. Speaking to the Lewiston Sun Journal on Monday, Collins stated that she doesn’t want to repeal the ACA until there’s a replacement “available,” but she said that Congress can’t do all the legislative changes required to have a successor law in place before approval of the repeal, and she said that a full bill would have to follow, “at nearly the same time,” to flesh out the program. On Tuesday, Collins’ office confirmed to The Free Press that those comments accurately describe her position on repeal.