On June 30, 2025, Maine Senator Susan Collins voted against a motion to strike any cut to Medicaid payments for substance use disorder treatment from the tax-and-spending bill, and against motions to remove its new paperwork requirements and its Medicaid cuts. Medicaid covers nearly half of nonelderly adults with opioid use disorder, and thousands of Mainers in addiction treatment get their coverage through Medicaid expansion.
Collins also voted to confirm Health Secretary Robert F. Kennedy Jr., whose department cut the Substance Abuse and Mental Health Services Administration to about half its staff, Education Secretary Linda McMahon, who halted $1 billion in school mental health grants, and the labor and Treasury secretaries whose departments stopped enforcing the 2024 mental health parity rule.
Susan Collins's Votes and Confirmations on Mental Health and Addiction
- Collins Voted Against Protecting Medicaid Payments for Addiction Treatment in June 2025. On June 30, 2025, Susan Collins voted no on a motion to send the tax-and-spending bill back to committee with instructions that would strike any provision that cuts Medicaid payments for substance use disorder treatment. It failed 47 to 53. Medicaid covers 47% of all nonelderly adults with OUD, and over half (56%) of those receiving medication to treat it, KFF found. Overdose deaths have fallen consistently since 2023, and Stateline reported that federal cuts could jeopardize that progress.
- Collins Voted Against Removing the Paperwork Rules and Medicaid Cuts That Threaten Mental Health Coverage. The same day, Susan Collins voted against a motion to remove provisions that cut benefits through the creation of new administrative burdens and paperwork requirements, and against a motion that would strike any provision that cuts funding for Medicaid. The two motions failed 48 to 52 and 47 to 53. Medicaid expansion is the primary coverage pathway for people with mental health or substance use disorders, KFF notes, and among Medicaid expansion enrollees specifically, 24% have a diagnosed behavioral health condition. The work requirement exempts only people with "disabling" mental disorders, and many who lose coverage will remain eligible for Medicaid but who did not successfully complete the paperwork, the Commonwealth Fund warned. When Arkansas tried a work requirement, it ended with over 18,000 people losing coverage.
- Collins Voted to Confirm Robert F. Kennedy Jr., Whose Department Cut the Federal Addiction Agency in Half. On February 13, 2025, Susan Collins voted to confirm Robert F. Kennedy Jr. as secretary of health and human services, and he was confirmed 52 to 48. Under Kennedy, the staff of the Substance Abuse and Mental Health Services Administration has shrunk by more than half to about 400 people, and the agency was losing all 10 regional offices and the Office of Treatment Services, Roll Call reported in November 2025. The agency is currently without an administrator and is missing other leaders, Stateline reported. In April 2026 the agency told grantees that treatment funds cannot be used for harm reduction services, including sterile syringes and fentanyl test strips.
- Collins Voted to Confirm Linda McMahon, Whose Education Department Halted $1 Billion in School Mental Health Grants. On March 3, 2025, Susan Collins voted to confirm Linda McMahon as secretary of education. In April 2025 McMahon's department said it would stop paying out $1 billion in federal grants that school districts used to hire counselors, psychologists and social workers. One district leader told NPR, "We're gonna end up going back to having two counselors in our" schools. A court order restoring the grants applies only to some grantees in the sixteen Democratic-led states that sued, AP reported.
- Collins Voted to Confirm the Secretaries Whose Departments Stopped Enforcing the Mental Health Parity Rule. Susan Collins voted to confirm Treasury Secretary Scott Bessent on January 27, 2025, Labor Secretary Lori Chavez-DeRemer on March 10, 2025 and Deputy Labor Secretary Keith Sonderling on March 12, 2025. On May 15, 2025, the Labor, Treasury and Health departments announced that "The Departments will not enforce the 2024 Final Rule" on mental health parity, the rule meant to make job-based health plans cover mental health and addiction care on the same terms as other care.
- Collins Voted to Confirm Mehmet Oz, Whose Agency Narrowed the Medicaid Exemption for People With Mental Illness. On April 3, 2025, Susan Collins voted to confirm Mehmet Oz as administrator of the Centers for Medicare and Medicaid Services. Oz's agency issued a June 2026 work-requirement rule that requires a condition to significantly impair a person's ability to work, and Georgetown's Center for Children and Families found that Fewer people will qualify as medically frail, the exemption that covers people with serious mental illness and addiction.
What the Mental Health and Addiction Cuts Under Susan Collins's Votes Mean for Maine
- Addiction treatment. 16,431 adults in Maine with a diagnosed opioid use disorder were on Medicaid in 2021, and 57 percent of them were covered through Medicaid expansion, the coverage group subject to the new work requirement, according to KFF data.
- Mental illness. Among Maine's Medicaid expansion enrollees, 18,776 had a substance use disorder and 28,026 had a mental illness in 2021, including 5,426 with a serious mental illness, according to KFF data. Each must now document work or prove an exemption to keep coverage once states start the requirement, no later than January 1, 2027.
Frequently Asked Questions About Susan Collins on Mental health and addiction
What is Susan Collins's record on mental health and addiction under Trump?
Susan Collins voted on June 30, 2025 against motions to protect Medicaid payments for addiction treatment and to remove the bill's new paperwork rules. She voted to confirm Robert F. Kennedy Jr., whose department cut SAMHSA's staff by more than half, Linda McMahon, who halted school mental health grants, and the secretaries who stopped enforcing the 2024 parity rule.
What happened to SAMHSA under the health secretary Susan Collins confirmed?
Susan Collins voted to confirm Robert F. Kennedy Jr. in February 2025, and by November 2025 SAMHSA had lost all 10 of its regional offices and more than half its staff. In January 2026 Kennedy's department also terminated about 2,000 SAMHSA grants and then reversed the move within days after members of Congress objected, a transient disruption recorded in KFF's tracker.
How did Susan Collins vote on Medicaid coverage for addiction treatment?
Susan Collins voted no on June 30, 2025 on the Gallego motion to strike any cut to Medicaid payments for substance use disorder treatment from the tax-and-spending bill, which failed 47 to 53. In Maine, 16,431 adults with opioid use disorder were on Medicaid in 2021, most of them through expansion.
Last updated: 2026-10-25