Sara Gideon’s Health Care ‘Plan’ Would Devastate Rural Hospitals, Increase Taxes, and Harm Patients

Gideon also fails to address important issues like: increasing access to home health care, increasing funding for diabetes and Alzheimer’s research, and combating drug shortages for life-saving medication. 

Senator Collins’ plan would lower health care costs & increase transparency for working families


“Sara Gideon wants the government to run health care, and she wants to pay for it by raising your taxes. Many rural hospitals are already struggling to even stay open, and Gideon’s plan would only increase the tremendous pressure on these hospitals - putting patient care at risk.” said Kevin Kelley, spokesman for Senator Collins’ campaign.

“In order to lower health care costs in Maine, we must tackle the underlying cost of health care.  Senator Collins’ health care plan is aimed at lowering these costs.  Senator Collins’ plan would increase price transparency so consumers know exactly what they’re paying for and how much it will cost.  Collins’ plan would reduce health care premiums for Mainers by 40% while continuing to protect those with preexisting conditions.  And it would help lower the prices of prescription drugs by increasing competition in the marketplace,” Kelley continued. 

Let’s take Gideon’s ‘plan’ line by line: 

Sara says she wants to “Reduce Health Care Costs and Expand Coverage”

Here’s what Sara’s plan would really do

The centerpiece of Sara Gideon’s government-run healthcare plan was rejected on a bipartisan basis when the ACA was created. Those with employer sponsored coverage already get charged higher prices for health services because Medicare and Medicaid pay so little. For example, Maine already pays physicians some of the lowest Medicaid rates in the country. Expanding federal price setting will raise prices for those with employer coverage and exacerbate hospital and physician office closures, particularly in rural areas. This will not increase competition with private plans -- it will lead to one-size fits all coverage and longer waits for appointments.

And here’s what Senator Collins has already done: 

Protecting individuals with pre-existing conditions.

Senator Collins is a steadfast champion of the 590,000 Mainers who live with pre-existing conditions such as asthma, arthritis, cancer, diabetes, and heart disease. 

Senator Collins has repeatedly spoken out against the Department of Justice’s failure to defend any portion of the ACA in court, including protections for individuals with pre-existing conditions.  

Senator Collins cast a decisive vote against repealing the Affordable Care Act and was the first Republican senator to speak out against repeal without an adequate replacement.  

Senator Collins was the only Republican to vote to block Trump Administration regulations that expanded short-term limited duration insurance plans, as such plans generally do not provide protections for enrollees who have pre-existing conditions. 

Senator Collins introduced the Diagnostic Odyssey Act which would enhance Medicaid coverage of advanced genetic testing options for children with severe undiagnosed illnesses.

Lowering health care costs.

Senator Collins has worked to lower health care costs by promoting competition, increasing transparency, and empowering consumers to make cost-consensus decisions.  

Senator Collins voted in favor of the Lower Health Care Costs Act, which contains 55 provisions to reduce health insurance premiums and lower prescription drug costs.  She is also a cosponsor of the Health Care PRICE Transparency Act, which would give consumers the upfront cost information they need to shop for the best deal. 

Senator Collins authored the Premium Reduction Act of 2019 that health care experts said would lower insurance premiums in the individual market by as much as 30 percent.  

Millions of Americans rely on the medical expense deduction to lower their annual tax bill, nearly half of whom have incomes of $50,000 or less. Senator Collins successfully lowered the income threshold to 7.5 percent for two years in the Tax Cuts and Jobs Act, and again secured extensions of the deduction for tax years 2019 and 2020 as part of a year-end funding bill that passed in 2019.  Senator Collins is pushing for a two-year extension of the medical expense deduction in the COVID-19 relief package.

Sara says she wants to “Increase Access to Affordable Prescription Drugs”

Here’s what Sara’s plan would really do

Senator Collins has supported lifting the prohibition on the Secretary of Health and Human Services' ability to negotiate drug prices in the past, but this policy can take a number of different forms and Sara does not specify what version she supports. According to a non-partisan Congressional Research Services analysis, a recent House passed bill may violate the constitution. Sen. Bernie Sanders' bill would create a Part D formulary, which could lead to crushing drug costs if a senior needs a drug that is not on that list. 

Here’s what Senator Collins has already done: 

As Chairman of the Senate Aging Committee, Senator Collins launched the Senate’s first bipartisan investigation into the causes, impacts, and potential solutions to egregious price spikes for certain off-patent drugs. This investigation culminated in a new law she authored to improve the FDA regulatory process and bring generics to market more quickly. Last year, the FDA approved a record number of generic drugs, which are cheaper for consumers.

Another law Senator Collins wrote banned pharmacy “gag clauses,” so now pharmacists can tell customers the cheapest way to pay for a medicine.  Before this law, nearly one out of four prescriptions filled through insurance ended up costing more for customers than if they had paid out of pocket. 

Senator Collins is an original cosponsor of the Prescription Drug Pricing Reduction Act of 2020—legislation that would save taxpayers $95 billion, reduce out-of-pocket spending by $72 billion, and lower premiums by $1 billion. Some of the significant savings come from changes to Medicare Part D that will protect seniors with an out-of-pocket spending cap.

Sara says she wants to “Mobilize Resources to Address COVID-19”

Here’s what Sara’s plan would really do

It’s impossible to assess Sara’s platitudes and vague policy proposals to respond to the biggest public health crisis our state and our nation has ever faced.  

Here’s what Senator Collins has already done: 

Sara claims she is responsible for $11 million to assist with Maine’s COVID-19 response.  By contrast, Senator Collins has secured more than $400 million in federal assistance for Maine hospitals and health care providers, including nearly $14 million for Community Health Centers.  

Senator Collins also helped secure more than $69 million to expand Maine’s testing capacity, which increased by 20 percent between July and August.  

While Sara cites flawed statistics about PPE, Senator Collins has worked to deliver 200,000 surgical masks, 650,000 face masks, and 260,000 N-95 masks to Maine. 

The most significant source of COVID relief to community health centers has been PPP, the small business relief program co-authored by Senator Collins. Nationally, health centers received $2.5 billion in PPP loans, amounting to an average loan of $2 million per health center. Congress also passed $14 million in funding for Community Health Centers in Maine.

In July, Senators Collins and Jack Reed (D-RI) sent a letter to leadership calling for $5.6 billion for COVID and flu vaccine infrastructure.

Sara said she wants to Ensure Access to Health Care in Rural Areas. 

Here’s what Sara’s plan would really do:

Sara’s ‘plan’ to support rural health care is a poor imitation of the strong action Senator Collins has already taken to ensure Maine’s rural residents have access to health services.  For example, Sara says she is “petitioning of the federal government to expand its Paycheck Protection Program to include hospitals that are in bankruptcy proceedings.”  Senator Collins is doing much more than “petitioning”-- she introduced a bipartisan bill in early July that would actually allow these hospitals to access the PPP she co-authored.  

Here’s what Senator Collins has already done

Senator Collins is recognized as a national leader on expanding access to health care for rural communities, which was reflected in an award she received from the National Rural Health Association for her work on these issues.  

To help prevent hospitals in rural communities from permanently closing their doors, Senator Collins joined Rep. Golden and Senator King in sending a letter to the SBA in early May urging it to amend its rules to enable critical access hospitals in bankruptcy proceedings -- like Calais Regional Hospital and Penobscot Valley Hospital -- to receive PPP loans to help them remain operational in the midst of the pandemic.

Senator Collins introduced the PPP for Critical Access Hospitals Act to allow nonprofit critical access hospitals undergoing Chapter 11 bankruptcy reorganizations to apply for forgivable loans under the Paycheck Protection Program.  This is the companion to Rep. Golden’s effort in the House. 

Senator Collins has also called for reducing the limit on "critical access hospitals" in rural areas. 

Senator Collins joined Senators Amy Klobuchar (D-MN) and Jacky Rosen (D-NV) in introducing bipartisan legislation to boost the number of doctors able to work in rural America. The Conrad State 30 & Physician Access Act would allow international doctors to remain in the United States upon completing their residency under the condition that they practice in underserved areas, such as rural communities.

To improve health care access in all corners of Maine, Senator Collins introduced the Training the Next Generation of Primary Care Doctors Act, which would expand the Teaching Health Centers Graduate Medical Education Program that trains doctors in underserved, community-based settings. 

Senator Collins is also the cosponsor of the Resident Physician Shortage Reduction Act of 2019, which would increase the number of Medicare reimbursed residency slots by 15,000 over five years, and the Rural Physician Workforce Production Act of 2019, legislation to support rural residency training and work to alleviate physician shortages in rural communities.

Sara said she wants to Protect and Expand Reproductive Rights. 

Here’s what Senator Collins has already done

Senator Collins has taken over 50 votes throughout her career in support of women's reproductive rights. While she has not agreed with Planned Parenthood 100 percent of the time, she has a stronger record than some Democrats. 

In 2017, the head of Planned Parenthood said that "women’s access to health care was truly on the line, and Senator Susan Collins never wavered."

In 2014, Senator Collins voted in favor of the motion to proceed to the Protect Women's Health from Corporate Interference Act. This bill, introduced by Senator Murray, is intended to restore access to contraceptive coverage for employees of closely-held for-profit corporations which can qualify for an exemption based on their religious freedom claims after the Hobby Lobby decision.  

Sara’s ‘plan’ also leaves a lot out…..

Here's a list of other critical health care issues that Senator Collins has worked on, which Sara overlooks in her plan:

Expanding Access to Home Health Care.

In January 2018, the RAISE Family Caregivers Act, a bipartisan bill authored by Senator Collins, was signed into law.  This legislation requires a coordinated strategic plan to leverage resources, promote best practices, and expand services and training available to caregivers.  In recognition of her outstanding advocacy and long-time leadership for home care and hospice, Senator Collins received the Home Care and Hospice Alliance of Maine’s Ruby Slipper Award in 2017.

Senator Collins has championed three bills that would tackle some of the top issues facing home health care agencies: 

  • The first bill, the Home Health Care Planning Improvement Act, which became law as part of the CARES Act, allows nurse practitioners, physician assistants and others to certify patients for home health services.

  • The second, the Home Health Payment Innovation Act, would assist agencies struggling to absorb years of reimbursement cuts by preventing inequitable and unwarranted payment rate reductions and expanding access to care in a cost-effective manner.  

  • The third bill, the Geriatrics Workforce Improvement Act, would help grow and train the next generation of geriatric health providers to meet the needs of older adults. This bill has been incorporated into the Title VII Health Care Workforce Reauthorization Act, which was passed by the Health Committee in December. 

Preventing Drug Shortages.

Senator Collins authored the Mitigating Emergency Drug Shortages (MEDS) Act with Senator Tina Smith (D-MN) to speed up approval of drugs in shortage, include greater reporting requirements on sources of Active Pharmaceutical Ingredients, and establish redundancy plans in the case of drug shortages.  Components of this bill were included as part of the Phase 3 coronavirus emergency response package that was signed into law on March 27, 2020.

Investing in Biomedical Research.

Senator Collins believes there is simply no investment that promises greater returns for America than our investment in biomedical research. As a senior member of the Senate Appropriations Committee, Senator Collins has successfully led efforts to increase overall funding for the National Institutes of Health, the largest public funder of biomedical research in the world, by $9.6 billion since fiscal year 2016, a 30 percent increase. This includes a $2.6 billion increase Senator Collins secured for the NIH in fiscal year 2020. 

In addition to supporting breakthrough medical advancements and improved patient outcomes, the State of Maine has also benefited from Senator Collins’ strong commitment to biomedical research.  In 2019, Maine received $112 million in NIH grants. The NIH funding for biomedical research generated more than $226 million in economic activity for Maine businesses and supported 1,672 jobs in 2018.  Additionally, in 2017, NIH funded institutions generated $24 million in tax fees and revenues for state, county, and municipal governments.   

Diabetes and Alzheimer’s Research. As founder and co-chair of both the Diabetes and Alzheimer’s Caucuses, Senator Collins has worked successfully to more than triple federal funding for diabetes research and secured the largest increase in history for Alzheimer’s research.  

Fighting Tick-Borne Illnesses.

The Kay Hagan Tick Act that Senator Collins authored became law in December 2019.  The law authorizes $150 million over a five-year period to improve research, prevention, diagnostics, and treatment for tick-borne diseases.

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