The Senate will not vote this week on the latest effort to repeal and replace the Affordable Care Act, after a third Republican senator came out against the bill Monday.

  • Sen. Susan Collins will not vote for Graham-Cassidy
  • Collins the third GOP senator after McCain, Paul
  • It means Senate does not have enough votes to pass the bill

Republican senators emerged from a closed-door meeting Tuesday and said there would be no vote on the Graham-Cassidy bill, effectively ending the latest attempt to get rid of former President Obama's signature legislation.

Republicans, who have spent the last several years trying to repeal ObamaCare, admitted Tuesday they do not have the votes.

Majority Leader Mitch McConnell told reporters after a closed-door luncheon in which the GOP decided not to hold the vote: “We haven’t given up on changing the American health care system. We aren’t going to be able to do it this week.”

But for right now, Republicans will move to the next priority, which is tax reform.

Maine Sen. Susan Collins says she will not vote for the Graham-Cassidy health care bills, and as the third NO vote, has effectively derailed the latest attempt to repeal the Affordable Care Act unless substantial changes are made.

"Health care is a deeply person, complex issue that affects every single one of us and one-sixth of the American economy," Collins said in her statement Monday. "Sweeping reforms to our health care system and to Medicaid can't be done well in a compressed time frame, especially when the actual bill is a moving target."

Collins says she opposes the different versions of the bill because of the sweeping changes and cuts to Medicaid it proposes, that it allows states to weaken protections for pre-existing conditions and that most doctor, patient, insurance and hospital groups agree the bill would lead to higher health insurance premiums and reduced coverage for millions of Americans.

Sens. John McCain and Rand Paul are also against Graham-Cassidy.

McCain decried the fact the bill did not go through the regular legislative process and involved the Democrats. Paul feels the bill should repeal the taxes included in the ACA. He also wants the block grants that help pay for Medicaid removed.

The NO votes of the three Republicans means the Senate Republican leadership does not have enough votes to pass the bill. All Democratic senators are currently voting against it.

Collins' announcement comes as the Congressional Budget Office announced the new bill would reduce insurance coverage for millions of Americans. The CBO says it could not give a more substantive analysis because it was not given enough time.

The CBO says the reduction in coverage would result from three causes: 

  1. A drop in Medicaid enrollment because of federal funding cuts
  2. A cut in subsidies would result in a lower enrollment in the individual insurance market
  3. Enrollment in all types of of insurance because penalties would be repealed

What would Graham-Cassidy do?

If passed, it would repeal the penalty for not having insurance. It also removes the penalty so that companies with 50 or more full-time employees no longer have to provide health coverage. 

Starting in 2020, the bill would repeal the ACA's Medicaid expansion and tax credits to pay for private coverage. Instead, the money would be redistributed to states in the form of block grants. 

Overall, states would see a cut of $215 billion in federal funding for health insurance through 2026. 

Adults without children who were covered under the Medicaid expansion would lose their coverage, or they may lose coverage for pharmacy, dental or vision health. 

The bill also allows the states to let insurers to set prices based on a person's health, which means pre-existing conditions or coverage for certain conditions will end up being more expensive.

Businesses will also be able to offer less comprehensive insurance policies.

Information from the Associated Press was used in this report.