Sen. Susan Collins, R-Me., questions Alex Azar, President Donald Trump’s nominee to become Secretary of Health and Human Services, during a Senate Health, Education, Labor and Pensions Committee confirmation hearing on Capitol Hill in Washington, Wednesday, Nov. 29, 2017. (AP Photo/Carolyn Kaster)

Maine Sen. Susan Collins, whose vote could make or break an effort to overhaul the nation’s tax system, offered several amendments Thursday to move the tax reform bill to the political center.

Collins’ proposals to add tax breaks for medical expenses, restore some state and local tax deductions, and improve the child care tax credit were among dozens of amendments offered by senators, ending Republican hopes of passing the bill late Thursday. Party leaders were rewriting the bill behind closed doors in hopes of voting on the proposal Friday.

The Senate also spent an hour debating an amendment proposed by Maine Sen. Angus King to send the bill back to committee so lawmakers could craft a revenue-neutral measure that “does not bust the deficit.” King’s amendment was in response to an analysis by the nonpartisan Joint Committee on Taxation that found that even when projected economic growth from the tax reform plan is taken into account, the bill would add $1 trillion to the national debt over 10 years.

In a floor speech introducing his amendment, King said the tax bill would affect Americans, businesses and the economy for a generation. He also lashed out at the way Republicans have gone about crafting the legislation.

“It’s the worst process I think I have ever seen in a public body,” King said. “The Bangor City Council would not amend the leash law using this process. We are talking about one of the most important bills any of us will ever vote on that has had zero hearings before the United States Senate.”

Collins had told Bloomberg in an October interview that she didn’t want to see tax reform “blow a hole” in the debt.

DEBATING BILL’S POSITIVES, NEGATIVES

Overall, the bill would give tax cuts to the wealthy while leaving more people without health insurance, triggering cuts to Medicare, ballooning the federal deficit and raising taxes on many Americans by 2027. Reform proponents argue that the corporate tax cuts at the heart of the bill would spur economic growth that would benefit all taxpayers.

The House approved a similar version of tax reform this month. Both the House and Senate would have to vote in favor of the same bill, and President Trump would have to sign it for it could become law.

Collins was one of three Republicans whose votes prevented repeal of the Affordable Care Act in July. Her opposition also helped to deep-six a second ACA repeal effort in September. As a moderate swing vote in a closely divided Senate, she is under intense pressure from both Trump and Republican leadership to support the bill, while Democrats, AARP, health care advocates and other grass-roots groups are clamoring for her to oppose it.

The bill would cut the corporate tax rate from 35 percent to 20 percent, while a myriad of changes to deductions, exemptions and tax credits would disproportionately benefit wealthy households, according to several independent analyses.

Many pro-business groups have lauded the reduction in the corporate tax rate. The plan would “implement numerous pro-growth reforms so that businesses large and small are granted much-needed relief,” said a Portland Press Herald op-ed by Grover Norquist of Americans for Tax Reform and Mary Adams, a Maine tax reform activist.

Collins on Tuesday sounded more optimistic about the bill after meeting with Trump, but by Thursday morning she told reporters at a Christian Science Monitor breakfast that she “had a lot of concerns that I’m trying to fix.”

Collins said it would be “very problematic for me” to vote for a bill that eliminates the deduction for state and local taxes, The Associated Press reported.

In remarks on the Senate floor Thursday, Collins advocated for four amendments, including one that would create a more generous deduction for medical expenses. The threshold to claim medical expenses would decline from 10 percent to 7.5 percent.

“Health care expenses can quickly become an unbearable burden,” Collins said, arguing that the amendment would provide “much-needed assistance” for those who use the deduction for expenses like long-term care. Other amendments would help employees of charities, churches and schools, preserve some of the deductions for state and local taxes and make a child care tax credit refundable.

Other Republicans were examining ways to make the vote more palatable, such as proposals floated by Sen. Bob Corker of Tennessee and Jeff Flake of Arizona that would trigger automatic tax increases or spending cuts if tax reform increased the deficit.

Meanwhile, a series of rallies and events were being held in Maine urging Collins to vote “no,” including gatherings Wednesday outside her Portland and Bangor offices and Thursday in Auburn.

Maine Democratic Party Chairman Phil Bartlett released a statement Thursday urging Collins to vote “no.”

“Three months ago, Mainers cheered when Senator Collins voted ‘no’ on the GOP’s effort to take away their health care. But if Senator Collins votes in favor of the Republican tax scam today, then she will erase that vote,” Bartlett said.

IMPACT ON OBAMACARE, MEDICARE

The Joint Committee on Taxation, which conducts tax analyses for Congress, estimated that in 2019, about 62 percent of Americans would get a tax cut of at least $100. But by 2027, because the tax cuts for individuals would expire while corporate tax cuts are permanent, 50 percent of Americans would see a tax increase, according to the Washington-based Tax Policy Center.

The Senate bill would eliminate the ACA’s individual mandate, which the Congressional Budget Office estimates would leave 13 million Americans uninsured and raise premiums by 10 percent. On Tuesday, Collins said Trump promised he would support two bills that would help shore up the ACA, including the Collins-Nelson reinsurance bill and the Alexander-Murray bill, both pending in Congress. Independent health policy experts, however, have said those bills, while helpful, would not nearly replace the damaging effects of repealing the mandate.

The tax reform bill also would trigger a 2010 deficit-control law that would require automatic cuts in Medicare and other federal programs. Collins has said she believes Congress would subsequently fix the Medicare cuts.

Collins said Senate Majority Leader Mitch McConnell has assured her that a separate vote would happen later to fix the Medicare cuts.

“I met with Senator McConnell just yesterday, and he has assured me that that will not be allowed to happen,” Collins said at the Christian Science Monitor breakfast, according to Talking Points Memo. “If it were going to occur, I would not even be considering voting for this (tax) bill.”

CONCERNS FOR OLDER AMERICANS

But other experts, such as Sam Berger of the Center for American Progress, a progressive think tank in Washington, said Republican leadership in the House and Senate would hold all the cards on subsequent votes and it’s far from a sure thing that Medicare would be protected.

House Speaker Paul Ryan has frequently come out in favor of shrinking Medicare, and a proposed House budget this year advocates slashing Medicare.

The $25 billion in Medicare cutbacks in 2018 would threaten the financial viability of hospitals, especially rural hospitals, said Jeff Austin, vice president of government affairs for the Maine Hospital Association.

“Medicare constitutes roughly 40 percent of hospital revenues, so even a small reduction in Medicare payments would have a significant negative effect on hospitals,” Austin said. “Maine’s nonprofit hospitals had an aggregate (operating) margin of 0.3 percent in 2016, with 19 experiencing a financial loss. There is no cushion at the vast majority of hospitals to absorb any more cuts.”

Lori Parham, state director for AARP Maine, said the organization is “very concerned” the Medicare cuts will go through because there’s “no guarantee” funding would be preserved.

“If the tax bill passes, older Mainers’ access to doctors, as well as emergency care and hospital rehab, among other services, could be in jeopardy,” Parham said. “These cuts would be even more dramatic for a rural, older state like Maine.”

But Annie Clark, a Collins spokeswoman, said in a written statement to the Press Herald that since the 2010 deficit-control law was enacted, “there has never, not once, been a single cut to Medicare or any other government program triggered by the enforcement of the (deficit-control) law. Since 2010, Congress has acted on a bipartisan basis 16 times to avert such a cut.”

Collins also wrote a letter Tuesday to McConnell urging “swift action” to prevent the Medicare cuts.

Staff Writer Kevin Miller contributed to this report.

Joe Lawlor can be contacted at 791-6376 or at:

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