GOP Sen. Rand Paul of Kentucky has announced his opposition, leaving Republicans at most one vote shy of the 50 votes needed. John McCain over the Arizona Republican's opposition to the latest effort to overhaul the nation's health law.
In the wake of that vote, McCain insisted he opposed any major legislation that didn't go through so-called "regular order:" committee hearings, a markup process to refine the bill and a score on the legislation's cost from the Congressional Budget Office.
Republican U.S. Senator Ted Cruz on Sunday said he opposes the latest version of a Senate attempt to repeal Obamacare, casting doubt on the healthcare bill's chances of passage, Politico reported.
Sen. Lisa Murkowski, R-Alaska, has not given any indication about which way she would vote, and her opposition would also scuttle the bill regardless of how Collins eventually decides.
Collins reiterated some of what's giving her pause, including the major changes the bill would make to medicaid, potential impact on premiums and deductibles and what she fears would be lesser protections for people with pre-existing conditions.
"I'm reading the fine print on Graham-Cassidy", she said, adding that for those with preexisting conditions, "the premiums would be so high they would be unaffordable".
For McCain, the decision is clearly one with his legacy in mind: He wants to do everything he can to restore comity and normalcy to the chamber he has called his work home since 1987. That defeat had been seen by many as the end of a seven-year campaign pledge by many Republicans to repeal Obamacare.
I know Rand Paul and I think he may find a way to get there for the good of the Party!
Among Democrats, 85 percent favor Obamacare over the Republican plan. With control of all the levers of executive and legislative power for the first time since 2002, there was some expectation that repeal and replace would be simple. Trump stood alongside Speaker Paul Ryan in a White House victory lap but it soon looked to be a premature celebration as the measure flagged in the Senate. Despite being as anti-Obamacare as anyone in the Senate, he doesn't believe the new bill goes far enough to replace it, calling it "Obamacare Lite". Collins and other Republicans have said leaders are considering changing the bill to attract votes.
Republicans need 50 of their 52 senators to vote for the bill under special budget rules that allow them to avoid the typical 60-vote threshold, which would require Democratic support. Trump spent the aftermath of the July repeal and replace failure berating McConnell for not being able to rally the votes.
"I would consider supporting legislation similar to that offered by my friends Senators Graham and Cassidy were it the product of extensive hearings, debate and amendment".
Collins' vote is key. Will he turn his fire on McCain?
Trump also is lashing out at Alaska Sen. Luther Strange tonight in Alabama. Over the weekend, her governor - independent Bill Walker, whom Murkowski has recently said she relied on for guidance - told The New York Times that he saw no world in which Graham-Cassidy would be workable in the state.
Graham is McCain's best friend in the Senate, but McCain says he can't support the bill in good conscience.
"There is a lot of pressure, but I've had a lot of pressure on a lot of different issues over the years", Collins said Friday according to the Press Herald.