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New focus on Maine's other centrist Republican senator
Collins could be a critical crossover vote on health-care reform

By Ceci Connolly
Washington Post Staff Writer
Thursday, October 22, 2009

BANGOR, MAINE -- A week ago, all eyes were on the senior senator from Maine, Republican Olympia J. Snowe, as she pondered the prospect of defying her party in support of a proposal to remake the nation's health-care system.

But after she voted with Democrats on the Senate Finance Committee, the what-will-Olympia-do buzz subsided, and now the junior senator from Maine is the fence-sitting Republican in President Obama's sights.

Wherever Sen. Susan Collins goes these days, people crowd around, trying to divine which way she is leaning.

"How does it feel to have everybody guessing?" Richard Dudman, 91, asked her after a ribbon-cutting ceremony at Husson University.

In the annals of Maine, a quirky, sparsely populated state with outsize political influence, it is only fitting that the senators would be on the receiving end of so much attention. Both women have bucked the GOP before, most notably on Obama's $787 billion economic stimulus package, and both understand the on-the-ground realities that make Maine desperately in need of health-care reform yet deeply skeptical about its impact.

For Snowe, with her modest upbringing and focus on social issues, the path to "yes" on Obama's ambitious overhaul was logical, though she reserved the right to go the other way on the final vote.

But for Collins, with her roots in small business and closer connections to the party infrastructure, the question of whether to back a Democrat-sponsored $900 billion package is more problematic.

"I really haven't made up my mind yet," she told Dudman, who, like most in the state, addresses the lawmakers by their first names.

Courting Collins

From the tiny college campus here to the Oval Office, from cable television studios to the K Street lobbying shops, people focusing on the fate of Obama's centerpiece policy initiative are dissecting every soft-spoken, noncommittal word Collins utters.

"She is masterful at gaining attention and making sure her particular issues are heard," said L. Sandy Maisel, a professor of government at Colby College in Waterville.

Already the courtship has entailed dinner with administration budget chief Peter Orszag, an invitation to confer with Senate Majority Leader Harry M. Reid (D-Nev.) and an hour-long session with White House Chief of Staff Rahm Emanuel, during which the president "dropped by" for 25 minutes. On Tuesday, Collins met with a group of centrist senators who are trying to forge a middle ground.

"I don't think it's hard for her to vote against leadership, but it may be hard for her to know [whether] the bill meets Maine's needs," said John J. Castellani, president of the Business Roundtable and a part-time state resident known to buttonhole lawmakers on the flight from Washington to Portland. "Maine doesn't care about political affiliation; it cares about what you do for Maine."

Technically, Obama has the 60 votes needed to break a filibuster in the Senate, if every Democrat and the chamber's two independents stick with him. But with such a fragile margin -- and the president's desire for even a hint of bipartisan support -- Snowe and Collins, who are not personally close and are at times competitive, could be critical crossovers.

On health care, Collins and her conflicting emotions reflect her home state. With an older, poorer rural population that depends heavily on small-business revenue, Maine grapples with many of the issues Obama aims to address.

Medical bills are increasing, largely because one insurer, Anthem, controls nearly 80 percent of the market, and delivering care in rural areas is often more expensive. Though proudly self-reliant, Maine residents are reeling from back-to-back recessions and are increasingly turning to the government for help. The state Medicaid program is overwhelmed, and primary-care doctors are hard to find.

Though the state's number of people without insurance is below the national average, its underinsured class is growing as individuals and small businesses choose bare-bones policies.

At the Bucksport Regional Health Center, Executive Director Jack Corrigan sees it in the rising number of clients seeking free or discounted care.

"It's because people don't have insurance or jobs or both," he said. "Insurance has become a concept. If you've got a $15,000 deductible, are you insured?"

Unlike most states, Maine has a government-sponsored insurance option, which Collins calls a disappointment. The program, named Dirigo, has limited enrollment to 10,000 people because of high costs. Rather than reducing the uninsured rate, it has drawn many out of private plans.

Defenders say Dirigo's shortcomings prove that states cannot solve health care alone. But Collins views it as a cautionary tale. She opposes a public option on the federal level and calls Snowe's idea to "trigger" the option if cost targets are not met within several years a "hair trigger."

Cost concerns

Collins is well-versed in the flaws of today's system, speaking in detail about the toll of chronic illness, the wide variations in the quality of care across the nation and the difficulties of creating a workable insurance market.

Several years ago, while she oversaw the state insurance commissioner's office, Maine enacted regulations prohibiting discriminatory practices such as denying coverage because of health status. But absent a requirement or incentive that young, healthy people participate, the change caused a spike in older, sicker customers, which has pushed up rates across the board.

"The primary issue for me is cost," Collins said in an interview.

Her worries about shifting costs to private payers have been sounded by the insurance industry in reports that Democrats criticized as "eleventh-hour attacks" that overlook key data.

"The approach they've used is self-defeating," she said of insurers. "They are raising legitimate concerns, but they should have been raised months ago."

Local newscasts are sandwiched between commercials by the U.S. Chamber of Commerce decrying $300 billion in new health-care taxes. But members of the Portland and Bangor chambers say they are inclined to support reform.

"Something needs to change," said Michael Bourque, a Portland executive who fits the Maine pattern of split-ticket voting for Obama and the two GOP senators. "I'm happy to see people working together."

Old Town businessman Joseph Cyr, however, frets about the cost of new government mandates on the already precarious economic climate. Today, the bus company owner pays one-quarter of the cost of health insurance for about 30 of his 200 employees.

"If I have to pay 25 percent on every one of those people, I make no money," he said.

For Collins, who was reelected last year with 61.5 percent of the vote, the health-care decision appears to be low risk with the potential for high reward. Maisel and other analysts predict that she will use her leverage, as she has in the past, to extract special considerations for her state.

In Maine, opposition to the health-care overhaul has been muted, almost deferential to the two political powerhouses: Snowe and Collins. Even skeptics such as Cyr say that in the end, they will trust the women they know as Olympia and Susan.

Research editor Alice Crites contributed to this report.

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