Sen. Susan Collins was one of three Republican senators who voted against passing the One Big Beautiful Bill Act in July 2025, and she cited the legislation’s many changes to Medicaid as the main reason. But an ad from a Democratic outside group falsely claims she “voted to support Donald Trump on the largest Medicaid cut in history.”
Democrats have criticized Collins, who is running for reelection in Maine, for her earlier procedural vote on a motion to advance the OBBBA to the Senate floor for consideration. But the ad ignores the fact that she ultimately voted against the bill instead of supporting it.
The nearly 30-second ad is sponsored by a group called Affordable Maine, which, as of Aug. 12, had spent more than $473,000 to air the TV and digital ad, according to AdImpact.
Collins is facing Democrat Troy Jackson, a former state Senate president, in the toss-up race.
The ad features an intensive care unit nurse who says she has “seen patients being bankrupted by the cost of care.” She then says, “This didn’t just happen. Susan Collins voted to support Donald Trump on the largest Medicaid cut in history.” At the end, the nurse says, “Healthcare is getting even more expensive. People are losing coverage, labor and delivery centers are closing, hospitals are closing. We need to tell Susan Collins to stop siding with Donald Trump. We can’t afford it.”
We reached out to Affordable Maine about its ad, but we have not yet received a response.
The ad only cites a May 21, 2025, post from Partners in Health that said the OBBBA included the “Largest Medicaid Cut in U.S. History.” The nonpartisan Congressional Budget Office later estimated that the law — which makes several changes to the Medicaid program, including eligibility requirements — will reduce federal Medicaid spending by more than $900 billion over a decade. The Medicaid provisions in the law will increase the number of uninsured people by 7.5 million, CBO also estimated.
But, as we said, Collins didn’t “support” the legislation, as the ad claims.
On July 1, 2025, when the Senate voted on whether to pass the bill, Collins joined the 47 senators in the Democratic caucus and Republican Sens. Thom Tillis and Rand Paul in voting against the OBBBA.
In a statement issued that day, Collins said while she “strongly” supported the legislation’s extension of tax relief for families and small businesses, her vote opposing it was “primarily” because of the impact the legislation would have on Medicaid.
“The Medicaid program has been an important health care safety net for nearly 60 years that has helped people in difficult financial circumstances, including people with disabilities, children, seniors, and low-income families. Approximately 400,000 Mainers – nearly a third of the state’s population – depend on this program,” her statement said. “Certainly, there are improvements that should be made to the Medicaid system. For example, I support work requirements for able-bodied adults who are not raising young children, who are not caregivers, or attending school. However, a dramatic reduction in future Medicaid funding, an estimated $5.9 billion in Maine over the next 10 years, could threaten not only Mainers’ access to health care, but also the very existence of several of our state’s rural hospitals.”
“While I continue to support the tax relief I voted for in 2017, I could not support these Medicaid changes and other issues,” which included the elimination of certain energy-saving incentives and tax credits for businesses and individuals, she said.
In the end, the reconciliation bill — which only required majority support to advance — passed when Vice President JD Vance, as president of the Senate, cast the “yea” vote that broke the 50-50 tie. Then, after the House of Representatives passed the amended Senate version of the bill, President Donald Trump signed it into law on July 4.
Collins’ Procedural Vote
On June 28, a few days before that vote, Collins did join 50 other Republican senators in voting to proceed with debate on the OBBBA. That debate ended with the vote on passage.
Collins later told Maine Public that she voted in favor of the motion to move forward on consideration of the bill because “the majority leader, whether it’s a Democrat or Republican, always has the right to determine which bills come to the floor, except under very few circumstances.” And she had also told reporters that her vote on passage would “depend on whether the bill is substantially changed.”
The Maine Democratic Party has criticized Collins for her procedural vote, which it called “a decisive vote to greenlight Medicaid cuts.” But while Collins could have voted not to advance the bill, that likely would not have stopped the OBBBA in its tracks.
Without Collins, the vote on the motion would have been 50-50. The vice president was present and prepared to make the tie-breaking vote to move the bill forward anyway.
Editor’s note: FactCheck.org does not accept advertising. We rely on grants and individual donations from people like you. Please consider a donation. Credit card donations may be made through our “Donate” page. If you prefer to give by check, send to: FactCheck.org, Annenberg Public Policy Center, P.O. Box 58100, Philadelphia, PA 19102.
