A last-ditch ObamaCare repeal effort by Republicans was all but dead on Monday after Sen. Susan Collins Susan Margaret CollinsThis week: Congress returns for first time since mass shootings Congress faces sprint to avoid another shutdown Democrats make renewed push for election security MORE became the third Republican to oppose the measure.

Collins announced her opposition minutes after the Congressional Budget Office released an analysis predicting that millions would lose insurance under the proposal if it became law.

That was enough for Collins, who had long been seen as an almost certain ‘no’ vote on the measure.

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She joins Sens. John McCain John Sidney McCainTop Arizona GOP official asks supporters to help stop 'gun grabber' Mark Kelly 'dead in his tracks' O'Rourke hits Meghan McCain for saying government taking away guns would cause 'a lot of violence' Sanders cites retiring lawmakers when asked which Republicans he could work with MORE (Ariz.) and Rand Paul Randal (Rand) Howard PaulGraham promises ObamaCare repeal if Trump, Republicans win in 2020 Conservatives buck Trump over worries of 'socialist' drug pricing Rand Paul to 'limit' August activities due to health MORE (Ky.) as GOP “no” votes. Republicans can only afford two defections and still muscle the bill through the Senate.

In a lengthy statement, Collins said the most recent ObamaCare repeal bill, which had been reshaped Sunday in an effort to win her over, “was as deeply flawed as its previous iterations.”

She cited the CBO’s score as one of her reasons for opposing the legislation authored by GOP Sens. Lindsey Graham Lindsey Olin GrahamTrump cancels secret meeting with Taliban leaders, Afghan president after attack Republicans grumble over Trump shifting military funds to wall Hurricane-hit bases among those losing funds to Trump wall MORE (S.C.) and Bill Cassidy William (Bill) Morgan CassidyRepublicans grumble over Trump shifting military funds to wall Push on 'surprise' medical bills hits new roadblocks Iowa professor resigns after saying he's affiliated with antifa MORE (La.), while also criticizing its cuts to Medicaid, its weakening of protections for people with preexisting conditions and predictions by insurers, hospitals and other groups that it would lead to higher premiums and less coverage for people.

Collins also decried a Senate process that she said had been rushed along.

“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,” said Collins, one of three Republicans along with McCain and Sen. Lisa Murkowski Lisa Ann MurkowskiTrump moves to permit new logging in Alaska's Tongass National Forest: report Innovation for the climate through innovative policy Overnight Energy: Green groups sue Trump over Endangered Species Act changes | Bureau of Land Management retirees fight plan to relocate agency | Wildfires in Amazon rainforest burn at record rate MORE (Alaska) to vote “no” on a previous slimmed-down ObamaCare repeal bill in July that appeared to end the debate.

“This is simply not the way we should be approaching an important and complex issue that must be handled thoughtfully and fairly for all Americans.”

It’s not clear whether Senate Majority Leader Mitch McConnell Addison (Mitch) Mitchell McConnellMajority fear mass shooting in their community: poll Top Democrats press Trump on background checks legislation The Hill's Morning Report - Congress returns: What to expect MORE (R-Ky.) will still try to hold a floor vote later this week, something some GOP donors and the White House may want to see just to get senators on the record.

“I think we’re going to need to have a meeting of our conference tomorrow ... so we can kind of see where everybody is before there will be any news,” Sen. John Cornyn John CornynTrump awards Medal of Valor, civilian honors to responders in Dayton and El Paso shootings The Hill's Morning Report - Congress returns: What to expect Cornyn faces toughest race yet in changing Texas MORE (R-Texas) told reporters after a meeting in McConnell’s office on Monday evening.

It’s possible there could be more defections than just the three public GOP “no” votes, as Republicans in the center and on the right have both raised reservations about the measure.

Republicans last week said a vote on the Graham-Cassidy measure was possible, though another public failure on ObamaCare could hurt McConnell’s caucus ahead of next year’s midterm elections.

The push came as Republicans faced a Sept. 30 deadline for passing ObamaCare repeal under special budget reconciliation rules that prevent Democrats from launching a filibuster.

The pressure to take advantage of those rules, plus an opening on the Senate schedule created by a debt-and-spending deal between President Trump and congressional Democrats, created room for the health-care repeal push.

Republicans had also heard an earful from conservative activists disappointed that the GOP had failed to repeal ObamaCare even with the White House and Congress in its control.

Even with the GOP effort seemingly at death’s door after McCain’s announcement of opposition on Friday, emotions were high throughout the day with repeal opponents seeking to build the pressure.

Scores of protesters, many of them in wheelchairs, jammed the GOP’s one-and-only hearing on the bill. Capitol Police had to drag some out of the hearing room.

Trump seems to sense the futility of the GOP effort.

“Looks like Susan Collins and some others who will vote against,” Trump said during an interview on the “Rick & Bubba” radio show on Monday. “We’re going to lose two or three votes and that’s the end of that.”

As criticism mounted over the weekend from health-care groups and senators, the bill’s main sponsors, Sens. Bill Cassidy (R-La.) and Lindsey Graham (R-S.C.) on Monday unveiled a revised version of the bill aimed at winning over Murkowski and Collins.

It kept the bill’s basic structure of repealing ObamaCare and creating block grants to deliver health-care funding to states, but offered additional Medicaid funding to Alaska and Hawaii.

Still, Alaska would receive slightly less federal funding than under ObamaCare even with the changes.

Paul, at a press conference on Monday, called the offer extra money for specific states “unseemly” and doubled down on his opposition.

“This was thrown together in a slipshod way,” Paul said. “Who would say we're going to vote on a trillion dollars worth of grants without even the CBO looking at it or anybody else?”

Cassidy and other proponents acknowledged problems with the process surrounding the bill, but cast their effort as an improvement on ObamaCare that would deliver power to states.

“I don’t defend this process,” Cassidy said at Monday’s hearing, while blaming Democrats for a lack of cooperation throughout the year.

The CBO did not give a specific number of people who would lose coverage in its estimate, but said it would be in the “millions.”

The bill also would reduce deficits by more than $133 billion over 10 years, CBO found, clearing a hurdle in qualifying for special rules to avoid a filibuster.

As the Senate Finance Committee held its hearing Monday, Democrats criticized the effort, saying it was just for show.

Dozens of protesters arrived outside the hearing room as early as 5 a.m., nine hours before the hearing began.

Chants of “No cuts to Medicaid, save our liberty” rang through the halls, and could be heard through the hearing room during the initial testimony.</s>With their Obamacare repeal bill on the brink of failure, Sens. Lindsey Graham and Bill Cassidy squared off with Sens. Bernie Sanders and Amy Klobuchar in a nationally televised debate Monday night and vowed to keep up their effort.

“We’re going to press on,” Graham said of his and Cassidy’s repeal bill, which appears all but dead amid firm opposition from three Republican senators. “It’s okay to vote. It’s okay to fall short.”

Graham (R-S.C.) and Cassidy (R-La.) sought to turn the health care debate into a referendum on the proposal by Sanders (I-Vt.) to create a single-payer system — an idea that two-thirds of Senate Democrats, including Klobuchar, of Minnesota, have not endorsed. Sanders’s presence on the debate stage had rattled Democrats who feared that he might spend more time his Medicare for All plan than defending the Affordable Care Act, but Sanders appeared determined to do both on Monday night.

“What the American people want is to build on and improve the ACA, not repeal it,” Sanders said during the debate, broadcast by CNN, while also calling for a “longer-term” transition toward a guarantee of “health care as a right.”

Cassidy immediately countered that “going to a single-payer system is not building on and improving” Obamacare, illustrating the GOP’s eagerness to portray the debate as a clash between ACA repeal and Sanders’s proposal. Michael Reed, research director at the Republican National Committee, argued in a Monday memo that the debate would pit “the Republican approach of more state flexibility and options for care vs. the Bernie Sanders approach of one-size-fits-all federal government control.”

Sanders defended single-payer as not “an extreme idea,” but he acknowledged that it “is not going to pass so long as my Republican colleagues control the Senate and House.” His legislation creating a single public health insurer has attracted support from five fellow potential contenders for the Democratic nomination to take on President Donald Trump in 2020, yet the party’s leadership has its support and vowed to keep their focus on shoring up Obamacare.

Sanders spokesman Josh Miller-Lewis said by email Friday that the Vermont senator’s “top priority in this debate is to expose Graham-Cassidy for what it is — the most destructive piece of legislation in the modern history of our country.”

Jennifer Palmieri, who served as communications director for Hillary Clinton during her primary battle with Sanders, also defended his and Klobuchar’s ability to keep the debate focused on Obamacare.

“While a single televised debate is far from a suitable substitute, it will provide an opportunity for Americans to hear about the devastating impacts this bill will have on millions,” said Palmieri, now with the Center for American Progress Action Fund.

“The vote on the floor isn’t Graham-Cassidy vs. Sanders,” she said. “It’s Graham-Cassidy vs. Affordable Care Act. No amount of Republican spin will change that underlying fact.”

Indeed, Sanders and Klobuchar took turns attacking the repeal bill, which counts three firm GOP opponents — Sens. Rand Paul of Kentucky, Susan Collins of Maine and John McCain of Arizona — as well as several others on the fence. Even as Trump tweeted Monday night to accuse McCain of flip-flopping on Obamacare, Graham reaffirmed that his friendship with McCain would not suffer over the potential failure of Republicans’ seemingly final attempt at repeal before its window to sidestep a filibuster closes.

“If we fall short, we’ll try to have a better process,” Graham told McCain from the debate stage. “No one respects you more than I do.”</s>(Bloomberg) — The latest Republican attempt to repeal and replace Obamacare appeared headed for defeat after Senator Susan Collins said she doesn’t see herself backing the plan and Texas Senator Ted Cruz said he’s currently ‘not a yes.’

Senate Majority Leader Mitch McConnell can afford to lose no more than two votes on the Graham-Cassidy health care bill. Two Republicans have so far said they oppose the measure. The White House continues to hold out hope that one, Rand Paul of Kentucky, can be persuaded to change his position — but the senator pushed back on the effort.

Collins said the bill has been rushed too fast for a thorough study of its full affects. She said her concerns include keeping protections for pre-existing conditions and not decimating Medicaid, the state-federal health program for the poor.
• Delta Air Lines says mysterious website tricks people who put pets on jets ‘It’s very difficult for me to envision a scenario where I end up voting for this bill,’ Collins said Sunday on CNN’s ‘State of the Union.’ ‘I have a number of serious reservations about it.’ In a separate appearance on CBS, Collins said the sole hearing to consider a measure that would drastically alter many elements of health care in the U.S., scheduled for Monday, is ‘not even close to enough.’

Collins was one of three Republicans to sink the previous effort to repeal and replace former President Barack Obama’s signature health care law, along with Arizona’s John McCain and Lisa Murkowski of Alaska, who hasn’t announced a position on the current measure.

The Senate must act by Sept. 30 to use a fast-track procedure that would keep Democrats from blocking the proposal. Republicans have pledged for seven years to overturn the law, and President Donald Trump made doing so a central theme of his 2016 campaign.

QuickTake Q&A: What’s in Last Republican Shot to Kill Obamacare

Given the opposition from Paul and McCain, a decisive ‘no’ from Collins would be enough to kill the measure, which may not be put up for a vote if its prospects seem doomed.

White House legislative director Marc Short said on ‘Fox News Sunday’ that the administration is trying to flip Paul’s vote, although the lawmaker appeared resolute in an appearance on NBC’s ‘Meet the Press.’

The Graham-Cassidy proposal would turn Obamacare funds into block grants for the states, which would create their own health care plans for residents. States that expanded Medicaid under Obamacare would be hardest hit by spending cuts, losing $180 billion from 2020 to 2026, according to the Kaiser Family Foundation. States that rejected the Medicaid expansion, many with Republican leadership, would gain $73 billion.

Paul said the Graham-Cassidy measure ‘basically keeps most of the Obamacare spending, almost all of the spending, and just reshuffles it.’ He said Medicaid block grants would shift money from Democratic-leaning states to Republican ones and set up a ‘food fight’ every time partisan control of Congress shifts.

‘I’ve always been a ‘yes’ for repeal,’ Paul said on NBC’s ‘Meet the Press.’ ‘This is a bad idea; it’s not repeal.’

Later, on Twitter, Paul said that he ‘didn’t run to put a cap ON Obamacare, I ran to put a cap IN Obamacare,’ adding ‘#nofakerepeal.’

Adding further uncertainty, Cruz raised the prospect of being another holdout if certain changes aren’t made to the bill. ‘Right now they don’t have my vote, and I don’t think they have Mike Lee’s either,’ he said during a panel discussion at the Texas Tribune Festival in Austin, referring to the Utah Republican.

The Republican drive to gut the Affordable Care Act is using a dramatically short-circuited process that seeks to replace the landmark health law with another introduced just two weeks ago.

McConnell has said he intended to hold a Senate vote in the coming week, before the deadline to use the fast-track procedure allowing a simple majority vote. Short said he thinks a vote will come on Wednesday.

Republican Senator Lindsey Graham, who brought the bill with Senator Bill Cassidy of Louisiana, said on ABC’s ‘This Week’ he thinks the measure still has a chance to pass and that there’s no possibility for a bipartisan repeal-and-replace effort that would bring Democrats into the process — an outcome that Collins urged.

‘We’re moving forward, and we’ll see what happens next week,’ Graham said. ‘I’m very excited about it.’

Graham made a plea to Paul to reconsider his opposition: ‘Rand Paul objects to the taxes, but when you look at the bill, Rand, we save a lot of money over time from Medicaid,’ Graham said on ABC. ‘We’ve put a cap on Obamacare growth to make it more sustainable, more affordable, more flexible.

Trump warned on Twitter on Friday that ‘Rand Paul, or whoever votes against Hcare Bill, will forever (future political campaigns) be known as ‘the Republican who saved ObamaCare.” The president continued on Saturday to call out Republican Senators who are either against the measure or haven’t stated their position.

A coalition of major health care stakeholders — including doctors, hospitals, and insurers — issued a joint statement on Saturday against the Graham-Cassidy bill, saying the Senate ‘should reject it.’

‘While we sometimes disagree on important issues in health care, we are in total agreement that Americans deserve a stable health care market that provides access to high-quality care and affordable coverage for all. The Graham-Cassidy-Heller-Johnson bill does not move us closer to that goal,’ said the coalition, which included the American Medical Association, the Federation of American Hospitals, and America’s Health Insurance Plans.

At least 21 million fewer Americans would have health-care coverage from 2020 to 2026 under the Graham-Cassidy plan, according to an estimate by the Brookings Institution.</s>Senator Susan Collins told CNN’s Jake Tapper that it’s “very difficult to envision a scenario” in which she would back back the Graham-Cassidy health care bill, and that she has “serious reservations” about it.

“What I am doing, as is my general practice, is I would like to see the Congressional Budget Office analysis, which is expected to come out tomorrow morning,” the Maine Republican said on CNN’s State of the Union.

Republicans are trying to jam Graham-Cassidy through on a rushed timeline with as little oversight as possible, and the CBO has said it does not have time to release a full analysis of the bill, which would likely show tens of millions of people losing insurance as a result. But Collins had already seemed like a probable no, telling the Portland Press-Herald on Friday that she was “leaning against” voting for it.

In a further blow to GOP efforts, Senator Ted Cruz – nobody’s idea of a moderate – said on Sunday morning that he Utah Senator Mike Lee weren’t yet on board with the bill either.

Collins was one of the three Republican senators who defeated “skinny repeal,” the GOP’s last effort to replace the Affordable Care Act, in July. (She received a hero’s welcome in Maine afterward.) John McCain, who dealt that bill its death blow, announced his opposition to Graham-Cassidy on Friday. If Collins does vote no, it would take just one more vote to blow up Obamacare repeal once again. Republicans have until September 30 to pass it under Senate reconciliation rules, which require only 50 votes; after that, they would likely – though not definitely – need to wait until next year for another shot at repeal.

Beyond McCain and Collins, the two Republicans most likely to vote no are Kentucky’s Rand Paul and Alaska’s Lisa Murkowski. Paul has been unstinting in his opposition to Graham-Cassidy because it doesn’t go far enough, and has said he “won’t be bribed or bullied” into supporting it. Murkowski voted against “skinny repeal” and has given no indication that she will support this version of repeal. Her state’s governor has also raised serious concerns. But Republicans have been busy trying to buy off her vote, and White House sources still maintain that both senators could be flipped.

Every Democrat, every health care group imaginable, and, perhaps most importantly, Jimmy Kimmel stand in opposition to the bill, which would gut Medicaid, slash protections to pre-existing conditions, and generally make life miserable for millions. Some Republicans appear to know how catastrophic Graham Cassidy’s effects would be, but will vote for it anyway to follow through on the longstanding GOP promise to repeal Obamacare.

It’s not clear whether Senate Majority Leader Mitch McConnell will hold a vote on Graham-Cassidy this week if he knows he lacks the votes to pass it , but White House Legislative Director Marc Short, after lying to Chuck Todd about its provisions, predicted that the Senate will take it up on Wednesday.</s>WASHINGTON: Republican senators tried to gather more support on Monday for a last-ditch attempt to repeal Obamacare by revising funding provisions of their bill to make it more attractive to a handful of undecided lawmakers.

The outcome remained in doubt, with several senators in the party voicing concerns in recent days about the legislation to dismantle Democratic former President Barack Obama's signature healthcare law.

Republican senators leading the effort on Monday released a revised version of their bill in hopes of finding more support.

The Senate is up against a Saturday deadline for deciding the fate of the 2010 Affordable Care Act, as it is known formally. That is the day for expiration of a rule that would let the latest Republican plan pass with just a 51-vote majority, instead of the more usual 60 votes. Republicans, who control the Senate 52-48, were finding it difficult even to clear that lower hurdle.

A total of three Republican defections would kill off the latest anti-Obamacare effort and Republican Senators John McCain and Rand Paul already have registered their opposition. Others senators such as Ted Cruz, Susan Collins and Lisa Murkowski have voiced reservations.

A spokesman for Paul said on Monday the senator still opposes the latest version despite the tweaks.

The revised bill released on Monday included a table that said some states where senators have been undecided, such as Alaska and Maine, would get more money under the bill than under current law. The Washington Post first reported the revision.

For seven years, Republicans have hammered Obamacare, which extended health insurance to some 20 million Americans, as an unwarranted and costly government intrusion into healthcare, while also opposing taxes it imposed on the wealthy.

Republican President Donald Trump made repealing Obamacare one of his top campaign promises in 2016. Democrats have fiercely defended it.

Democratic leaders roundly rejected the revised draft of the repeal legislation as a sleight of hand to gain support.

The last attempt to repeal Obamacare fell one vote short in July, in a humiliating setback for Trump and Senate Majority Leader Mitch McConnell.

The new bill, originally introduced by Senators Lindsey Graham and Bill Cassidy, would take federal money spent on the Medicaid program for the poor and disabled, as well as subsidies to help Americans buy private insurance, and divvy it up to the states in block grants. Advocates say that would give states more discretion to manage their own healthcare schemes.

Opponents fear undoing Obamacare will mean millions lose healthcare, including some with pre-existing medical conditions.

U.S. hospital stocks were down across the board, in broadly bearish trading marketwide. Shares of HCA Healthcare Inc and Tenet Healthcare Corp were hit particularly hard, falling 2.8 percent and 5 percent, respectively, in afternoon trading.

"The Graham-Cassidy bill is looking to reduce funding for Medicaid in the longer term," said Jefferies analyst Brian Tanquilut. "That is a benefit that we have seen improve the earnings outlooks for these hospitals."

He said the bill could reduce the number of insured Americans, which would hurt hospitals' bottom lines.

Paul, from Kentucky, said the Graham-Cassidy plan was still too similar to Obamacare. "My promise to the voters was to repeal Obamacare - not block grants and keep Obamacare," Paul said in a statement. Only a "significant reassessment" of the "trillion-dollar spending regime" would get his support, he said.

Cruz, a conservative speaking at an event in his home state of Texas, warned on Sunday that Trump and McConnell could not count on his vote. Cruz has pushed for greater government cost savings in healthcare.

Collins, a moderate from Maine who voted against her party's bill in July, said on CNN's "State of the Union" on Sunday that it was difficult to "envision a scenario where I would end up voting for this bill." She worried about cuts to Medicaid benefits to the poor and disabled.

Graham suggested Republicans could have another shot at repealing Obamacare, even if they do not do it this week, if Senate leadership were to attach a repeal bill to a planned tax reform package.

That package was expected to be designated in 2018 for the once-per-year procedural advantage of being handled under the Senate's 50-vote reconciliation process. Trying to combine the two would be highly unusual.

"If we fall short, then you just continue the effort in putting taxes and reconciliation together," Graham told Reuters. "I think Congress can do two things at once."

U.S. Senate Democratic leader Chuck Schumer dismissed the late effort to revise the bill and add money for a few states, calling it "just as bad for those states and the rest of the states because it still contains a massive cut to Medicaid."

The Senate Finance Committee is scheduled to hold a hearing on Monday in an attempt to build support for the bill and to tamp down Democratic criticism that the measure has not been thoroughly vetted.

The non-partisan Congressional Budget Office is expected to produce as early as Monday a preliminary analysis of the bill that would assess its impact on budget deficits.

More time is likely needed for the CBO to gauge how the bill could affect Americans' access to health insurance.</s>Sens. Bill Cassidy, R-La., and Lindsey Graham, R-S.C., will serve up a new version of their bill overhauling Obamacare on Monday, even as the whole grand effort appears headed for a meltdown. The new version still kind of looks the same as the old one. But it apportions bigger slices of federal health spending to the states of key senators who were leaning against -- or outright opposed -- to the original bill, endangering its success.

If you read the updated bill, which was leaked Sunday night to The Washington Post and other news outlets, it's pretty clear which senators Cassidy and Graham are playing to. A state-by-state summary claims Alaska would get 3 percent more funding, Arizona would get 15 percent more funding and Maine would get 43 percent more funding from 2020 and 2026 compared to current law.

Senators from all three of those states - Lisa Murkowski, John McCain and Susan Collins - had backed away from the bill in recent days. McCain indicated on Friday he'd oppose the bill because it wasn't going through regular order, while Collins and Murkowski said they want to better understand how it would affect their own states.

With Sen. Rand Paul, R-Ky., still insisting he won't back the bill, nabbing two of those three senators is crucial. Senate Republicans have just five days left to pass a measure repealing and replacing big parts of the Affordable Care Act. Their opportunity runs out on Oct. 1, when the budget reconciliation bill around which they'd based their entire strategy expires.

Acutely aware of the stakes, Senate GOP leadership and the White House are engaged in an all-in effort to rally the votes. But it's far from clear that they can get all but two Republicans to swallow this latest Cassidy-Graham iteration.

The plan was distributed among Republicans late Sunday. Aides to Murkowski and Collins did not immediately comment. Some Republicans close to the process have long counted Collins as an eventual "no," predicting that little could be done to the bill to change her mind. On Sunday night, some were once again privately pessimistic the changes would convince her to vote yes.

McCain is unlikely to bite. Even if the Senate Finance Committee considers Cassidy-Graham 2.0 in its high-profile health-care hearing Monday afternoon, there wouldn't be nearly enough time for the Congressional Budget Office to score it before a vote this week. Lawmakers do expect an analysis from the CBO Monday, but it will be based on the first version of Cassidy-Graham. And that's a far cry from the "regular order" McCain has called for.

But Cassidy and Graham, who have argued that Republicans must pass a bill repealing much of the Affordable Care Act or face serious retribution from their core voters in next year's midterms, are pressing forward. They will present their new bill as more equally distributing federal health-care spending among the states, so that no one state faces a big funding cliff.

The duo is still taking the same basic approach to revamping the ACA: The bill gathers its subsidies for private coverage and its Medicaid expansion, lumps together all of that spending, cuts it somewhat, and redistributes it to states in the form of block grants.

Under the first Cassidy-Graham bill, that would have resulted in a median change of 11 percent less funding for states that expanded Medicaid and 12 percent more for states that didn't, according to an analysis by the nonpartisan Kaiser Family Foundation. But there was a wide variation in the block grant funding; Mississippi would get 148 percent more relative to current law, while New York would get 35 percent less from the federal government, Kaiser had estimated.

The new version doesn't change the total sum of money the federal government would spend on the block grants from 2020 to 2026. Instead, it tries to smooth out the formula in what its sponsors hope is an effort to put states on a more equal footing. But the new version also creates some winners and losers: South Dakota would see the largest funding increase (88 percent) while Oregon would lose the most federal funding (17 percent).

--Let's look at Alaska and Maine. Kaiser had estimated the first version of Cassidy-Graham would result in 8 percent less block grant funding for Alaska; Republicans claim that under their latest bill Alaska would get 3 percent more. Kaiser had also estimated that Maine would get 8 percent more under the initial measure; it would get 43 percent more under the revised version of the bill, according to the GOP documents.

But let's also throw in an important caveat here: The estimates that Cassidy and Graham will publicly release Monday make some assumptions that independent analysts say are rather disingenuous.

For one thing, the state funding estimates don't take into consideration the bill's additional cuts to regular Medicaid spending. If those cuts were considered, it would be clear that states like Alaska and West Virginia would still be losing out on federal funds overall. And the GOP estimates also assume that states would slash their own funding for coverage and then factor that into the final number as "state savings."

Of course, opponents of Cassidy-Graham noted these things -- and kept sharply criticizing the bill overall -- Sunday night and into the early morning hours. Reporters also pointed out how the Republican estimates could be misleading:

From the Wall Street Journal's Michelle Hackman who tweeted:

2) do not factor in significant medicaid cuts"

From the Center on Budget and Policy Priorities's Jason Leibenluft who tweeted:</s>Sen. Ted Cruz said Sunday that Republican leaders can’t count on his vote for the GOP’s latest Obamacare repeal effort, as it currently stands, and that he suspects Sen. Mike Lee of Utah feels the same way.

“Right now, they don’t have my vote, and I don’t think they have Mike Lee’s, either,” Mr. Cruz said at the Texas Tribune Festival in Austin, referring to the Republican senator from Utah and one of his close friends.

“Now, I want to be a yes. I want to get there because I think Obamacare is a disaster,” he said.

He said it depends on what’s in the package and that the legislation being pushed by GOP Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana has some “very good elements.”

He said the best element of the Graham-Cassidy bill is the provision that would take federal Medicaid expansion money under Obamacare and block-grant it back to the states.

Republicans are trying to cobble together 50 votes to get the bill across the finish line this week, and can afford no more than two GOP defections in the Senate assuming no Democrats vote for it.

GOP Sens. John McCain of Arizona and Rand Paul of Kentucky have voiced their opposition, and GOP Sen. Susan Collins of Maine said Sunday on CNN it would be difficult to see a scenario where she would support it.

Mr. McCain and Mrs. Collins have expressed reservations about what they see as a rushed process, and Mr. Paul is opposed to the Medicaid block-grant provision, saying it effectively preserves part of Obamacare.</s>Sen. Susan Collins of Maine was the fourth GOP senator to announce she will not vote for Republicans’ last-ditch plan to finally repeal ObamaCare – signaling an end to the bill.

Collins said Monday that the Graham-Cassidy bill, chiefly written by Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, was “deeply flawed.” She joins Sens. Rand Paul, John McCain and Ted Cruz in opposition of the legislation – although Cruz reportedly could change his vote if certain adjustments are made to the plan.

The Graham-Cassidy bill got some last-minute revisions over the weekend in an effort to garner more support, specifically from Sen. Lisa Murkowski, R-Alaska, who has not announced her decision.

The legislation, largely seen as a Hail Mary pass by Republicans to make good on their years-long promise to eradicate ObamaCare, can only afford to have two Republicans vote against the bill without any support from Democrats before it's doomed.

President Donald Trump has strongly peddled the Graham-Cassidy legislation, specifically on Twitter, and urged senators to vote for it.

Senate Republicans scrambled ahead with the new plan since they have until September 30 to push through health care reform using a special procedure to avoid a filibuster. However, Republicans are reportedly hesitant to bring this latest effort to a vote.

Read on for a look at what the Graham-Cassidy bill does.

What does the legislation do?

The Graham-Cassidy legislation would implement a block grant program that gives funding to states, which would then have a wide leeway on how that money is spent.

“We’ll allow [the] states to come up with solutions to help sick people, not just some bureaucrat in Washington,” Graham told Fox News.

“We’ll eliminate the individual mandate, the heart and soul of ObamaCare, that is gone at the federal level. We take the money and send it back to the states in a block grant formula where they can administer health care,” Graham added.

The plan would eliminate Medicaid expansion, tax credits, employer mandates and cost-sharing subsidies. It would let states ease coverage requirements.

New provisions were added over the weekend that would allocate additional money to Alaska and Wisconsin. Among others, one provision allowed for an increase in Medicaid funding to states with a high population of Native Americans, including Alaska.

Consulting firm Avalere Health predicted that Graham-Cassidy would “significantly” reduce federal funding to states by $215 billion by 2026.

Avalere also said states with a higher number of individuals in insurance affordability programs and Medicaid would face a greater impact. California would suffer the greatest loss, it said.

Sen. John McCain, R-Ariz., previously said that he would “reluctantly” vote for the measure if Gov. Doug Ducey supported it – which he does.

But McCain said Friday that he would have considered the bill from his "friends" if "it were the product of extensive hearings, debate and amendment."

"We should not be content to pass health care legislation on a party-line basis, as Democrats did when they rammed ObamaCare through Congress in 2009," McCain said.

REPUBLICANS WONDER ALOUD IF A HEALTH CARE VOTE IS WORTH THE PAIN

Sen. Lisa Murkowski, R-Alaska, who also voted against the previous “skinny repeal” in July which failed 51 to 49, has not signaled what her decision will be.

Sen. Rand Paul, R-Ky., was the first Republican who said he would vote against the bill.

Paul said the plan would further increase the nation’s debt and doesn’t “repeal a single ObamaCare insurance regulation” such as essential health benefit rules.

The bill needs 50 votes to pass, with Vice President Pence potentially casting a tie-breaking vote. Pence said he’s “all in” for the plan.

What does the Congressional Budget Office say?

The Congressional Budget Office released a preliminary assessment of the bill Monday that does not provide “point estimates that are typical” in analyses because of time constraints.

Along with the Joint Committee on Taxation, the analysis estimated that the proposal would reduce the on-budget deficit by at least $133 billion. It would also lower the number of people with comprehensive health insurance by “millions.”

“That number could vary widely depending on how states implemented the legislation, although the direction of the effect is clear,” the analysis said.

Fox News’ Chad Pergram and The Associated Press contributed to this report.</s>U.S. Senator Susan Collins rebuffed intense lobbying from fellow Republicans and the promise of more money for her state in deciding on Monday to oppose - and likely doom - her party's last-ditch effort to repeal Obamacare.

The most moderate of Republican senators joined John McCain and Rand Paul in rejecting the bill to end Obamacare, a top priority for President Donald Trump, who pressured Collins in a call on Monday. A sweeping cut in funding to Medicaid, a program for low income citizens and disabled children, was the main reason for opposing the bill, she told reporters.

"To take a program that has been law for more than 50 years, and make those kinds of fundamental structural changes ... and to do so without having in depth hearings to evaluate the impact on our most vulnerable citizens was unacceptable to me," Collins said outside the Senate chambers.

She also opposed the bill for weakening protections for people with pre-existing conditions, such as asthma, cancer and diabetes.

"So for those reasons, I cannot support the bill," Collins said.

Collins' decision came even after the sponsors of the bill, Senators Lindsey Graham and Bill Cassidy, offered a boost in federal health care funds of more than 40 percent for her state, Maine.

For seven years, Republicans have vowed to get rid of Democratic former President Barack Obama's signature healthcare law, which extended health insurance to some 20 million Americans. They believe it is an unwarranted and costly government intrusion into healthcare, while also opposing taxes it imposed on the wealthy.

Republicans, who hold a slim 52-48 majority in the Senate, are up against a tight September 30 deadline to pass a bill with a simple majority, instead of the 60-vote threshold needed for most measures. Senate Majority Leader Mitch McConnell wanted to hold a vote this week, but it is not clear he will do so now that three senators have said they will cast "no" votes.

Graham dismissed notions that the bill was the last chance for Republicans to get rid of Obamacare and pledged to keep working on the legislation.

Democrats kept up their pressure for killing the bill. In an evening speech on the Senate floor, Senate Democratic leader Chuck Schumer said, "The Trumpcare bill would gut Medicaid, would cause millions to lose coverage, cause chaos in the marketplace."

Schumer said once repeal of Obamacare is off the table, Democrats want to work with Republicans "to find a compromise that stabilizes markets, that lowers premiums."

Collins and McCain, who voted against the last major repeal effort in July, have both advocated for a bipartisan solution to fixing the parts of Obamacare that do not function well.

U.S. hospital stocks were down across the board as the bill struggled. Shares of HCA Healthcare Inc and Tenet Healthcare Corp were hit particularly hard, falling 2.5 percent and 5.7 percent, respectively, on Monday.

"The Graham-Cassidy bill is looking to reduce funding for Medicaid in the longer term," said Jefferies analyst Brian Tanquilut. "That is a benefit that we have seen improve the earnings outlooks for these hospitals."

Collins announced her opposition shortly after the non-partisan Congressional Budget Office said that the number of people with health insurance covering high-cost medical events would be slashed by millions if it were to become law.

CBO also found that federal spending on Medicaid would be cut by about $1 trillion from 2017 to 2026 under the Graham-Cassidy proposal, and that millions of people would lose their coverage in the program, mainly from a repeal of federal funding for Obamacare’s Medicaid expansion.

The Trump administration, including Health Secretary Tom Price had lobbied her hard in recent days, Collins said.

“The president called me today, the vice president called me in Maine over the weekend, Secretary Price has called me, it would probably be a shorter list of who hasn’t called me about this bill,” she said.

Trump had not called Collins before the vote in July.

The Senate held its first hearing all year on the proposed Obamacare repeal on Monday, but it was immediately disrupted by protesters who forced Senate Finance Committee Chairman Orrin Hatch to postpone its start by about 15 minutes.

The protesters, mainly from a disability rights group and many of whom were in wheelchairs, were forcibly removed one-by-one from the hearing room as they yelled, "No cuts to Medicaid, save our liberty." The hearing eventually proceeded for about five hours, but protests could be heard outside for more than an hour.

Police arrested 181 demonstrators, including 15 in a senate hearing room. Police removed some protesters from their wheelchairs and carried them out by the arms.

Television talk show host Jimmy Kimmel, who had become part of the debate on U.S. healthcare legislation in May after discussing his newborn son's heart surgery, had taken aim at the bill in recent days. On Monday he tweeted: "Thank you @SenatorCollins for putting people ahead of party. We are all in your debt."

A new CBS poll released earlier on Monday said that a majority of Americans - 52 percent- disapprove of the Graham-Cassidy bill. It said only 20 percent of those polled approved. The poll was taken between Sept. 21 and 24.</s>Republican authors behind a last-ditch plan to overhaul ObamaCare struggled Monday to win over Senate holdouts, even after reworking the state-funding formula in the latest version of the legislation.

In the latest setback, a spokesman for Sen. Rand Paul, R-Ky., whom President Trump tried to woo over the weekend, said the Kentucky lawmaker has not budged from his opposition.

Paul's state was among those seeing a funding increase under the latest version of the "Graham-Cassidy" bill, but the Republican has concerns the plan would spend too much without really replacing ObamaCare.

Sponsors Lindsey Graham, of South Carolina, and Bill Cassidy, of Louisiana, are trying to win over support from the chamber’s GOP holdouts. A new chart released by Cassidy's office shows a range of states getting extra health care funding, including those represented by each one of those GOP holdouts: 4 percent more for Kentucky; 49 percent more for Texas; 3 percent more for Alaska; 43 percent for Maine and 14 percent more for Arizona than under current law.

Sen. John McCain, R-Ariz., joined Paul last Friday in opposing the bill, setting off the scramble to either win over Paul or at least convince other wavering senators to support the bill. Republicans can only afford to lose two senators on the floor.

The focus is heavy on Alaska, where GOP Sen. Lisa Murkowski does not want to back any measure that would increase the state’s already sky-high cost of providing health care in its many remote, rural communities.

Yet, while the latest funding boost for Alaska would not appear that significant, the boost for Maine is substantial. The state is represented by Sen. Susan Collins, who has been leaning "no" on the bill for days.

The bill would provide block grants to states, allowing them to execute to their own plan to manage a federally backed health care program.

White House legislative affairs Director Marc Short acknowledged on “Fox News Sunday” that the bill’s funding formulas were being revised over the weekend.

However, Cassidy’s office has not responded to requests to explain the new state-by-state data in more detail.

Collins and Murkowski, along with McCain, voted no in July when the GOP-controlled Senate held its only final floor vote this year on a full ObamaCare repeal-replace measure.

The failed effort has soured President Trump on Senate Republicans, who hold a 52-48 majority in the chamber, considering Trump made repealing ObamaCare a major campaign promise.

Republican have until Saturday to pass the bill by a simple, 51-vote majority under so-called budget reconciliation rules, with the potential for Vice President Pence to cast a deciding yes vote.

Trump this weekend continued to try to rally votes and suggested that Alaska and Maine would be among several states to benefit from the new bill, if passed.

“Alaska, Arizona, Maine and Kentucky are big winners in the Healthcare proposal. 7 years of Repeal & Replace and some Senators not there,” Trump tweeted Sunday.

Arizona is the home state of McCain, who cast the decisive no vote in July and on Friday said he wouldn’t vote for the new bill.

Trump, in response, blasted McCain while turning his attention to Paul.

Trump on Saturday tweeted: “I know Rand Paul and I think he may find a way to get there for the good of the Party!”

An analysis released last week by the firm Avalere Health showed 34 states getting less funding -- with Arizona, California and New York among those appearing to face the deepest cuts.

Texas stood to get the biggest increase -- $35 billion -- and states overall would get $215 billion less through 2026, according to the report.

“The Graham-Cassidy bill would significantly reduce funding to states over the long term,” said Avalere Vice President Caroline Pearson. "States would have broad flexibility to shape their markets but would have less funding to subsidize coverage for low- and middle-income individuals."

On Monday, House Minority Leader Nancy Pelosi, D-Calif., said the weekend “tweaks” to Graham and Cassidy’s bill “only worsen the crushing costs and cruelty their bill inflicts on millions of Americans with pre-existing conditions and working families.”
United States Senator Susan Collins says she will vote "no" on the Graham–Cassidy bill joining Senators John McCain and Rand Paul and possibly ending the most recent effort to repeal Obamacare.