On June 30, 2025, Susan Collins voted against an amendment to extend the enhanced premium tax credits, and on September 30, 2025 she voted against a funding bill that would have made them permanent. The credits expired at the end of 2025.
In January 2026 Collins voted against taking up a resolution to overturn the administration's marketplace rule, which added stricter enrollment and eligibility procedures. She had voted to confirm Mehmet Oz, whose agency wrote it.
Susan Collins's Votes on Premium Tax Credits and Marketplace Rules
- Collins Voted Against Extending the Premium Tax Credits in the One Big Beautiful Bill Act in June 2025. On June 30, 2025, Susan Collins voted no on an amendment to "extend the enhanced premium tax credits and increase the individual tax rate for taxpayers with income over $10,000,000," and all 53 Republican senators voted no. After the credits expired, enrollees' premium payments rose 58% on average in 2026, from $113 to $178 a month, and average deductibles reached a record $3,786.
- Collins Voted Against a Funding Bill That Would Have Made the Premium Tax Credits Permanent in Fall 2025. On September 30, 2025, Collins voted no on S. 2882, a funding bill with a permanent extension of enhanced tax credit, and on October 9 she again voted against taking it up. Insurers now cite the expiration of enhanced premium tax credits at the end of 2025 and a related increase in the risk pool's morbidity as a reason for higher 2027 rates, with a median proposed premium increase of 15%.
- Collins Voted to Keep the Administration's Marketplace Paperwork Rule in January 2026. On January 13, 2026, Collins voted against taking up S.J.Res. 84 to overturn the Centers for Medicare & Medicaid Services' marketplace rule, which added stricter enrollment and eligibility procedures, including additional verification of income. The agency estimated the rule would add between 725,000 and 1.8 million uninsured people in 2026; KFF reports that some of its requirements are on hold due to pending litigation but could lead to further enrollment decline if they take effect.
- Collins Voted to Confirm Mehmet Oz, Whose Agency Tightened Marketplace Enrollment, in April 2025. On April 3, 2025, Collins voted to confirm Mehmet Oz to run the Centers for Medicare & Medicaid Services. His agency finalized the stricter marketplace rule and is working to make it easier to enroll in short-term plans that, unlike marketplace insurance, can reject consumers based on their medical history.
- Collins Voted to Keep Prior Authorization in Traditional Medicare in July 2026. On July 16, 2026, Collins voted against taking up a resolution to end the WISeR model, under which vendors reviewing Medicare patients' requests receive a share of the savings associated with services that are denied. The resolution died on that vote, so the six-state pilot continues.
- Collins Voted Against Preserving the Premium Tax Credits in February 2025. On February 21, 2025, Collins voted no on an amendment for a reserve fund "preserving and extending" the enhanced premium tax credits in the first budget resolution, and it failed 48 to 52. Effectuated enrollment in Marketplace plans fell for the first time in seven years in 2026, KFF reports.
What Susan Collins's Votes on Premium Tax Credits Mean for Maine Marketplace Enrollees
- Coverage dropped. Effectuated marketplace enrollment in Maine fell 12%, from 62,381 in 2025 to 54,800 in 2026, after the enhanced credits expired.
- 2027 rate requests. Maine marketplace insurers requested 2027 changes ranging from 6.19% (Harvard Pilgrim Health Care) to 19.51% (Maine Community Health Options); these are requests, and final rates may differ.
Frequently Asked Questions About Susan Collins on Insurance costs
What is Susan Collins's record on health insurance costs under Trump?
Susan Collins voted on June 30, 2025 against an amendment to extend the enhanced premium tax credits and on September 30, 2025 against a funding bill that would have made them permanent. In January 2026 she voted to keep the administration's stricter marketplace enrollment rule, written by the agency of Mehmet Oz, whom she voted to confirm. In February 2025 she also voted against a budget reserve fund for preserving and extending the credits.
Did Susan Collins vote to confirm Dr. Oz, who now runs the ACA marketplaces?
Yes. Susan Collins voted to confirm Mehmet Oz to run the Centers for Medicare & Medicaid Services on April 3, 2025. In September 2026 his agency canceled approximately 315,000 marketplace enrollments, a sweep that KFF says likely dropped some legitimately enrolled consumers.
Did most people want Congress to extend the ACA tax credits that Susan Collins voted against extending in June and September 2025?
Yes. Susan Collins voted against the June 30, 2025 amendment and the September 30, 2025 funding bill that would have extended the enhanced premium tax credits, and in a January 2026 KFF poll, 67% of the public said Congress did the "wrong thing" by not extending them.
Last updated: 2026-10-25