Susan Collins is running a new campaign ad. In it, she tells Mainers that "when Medicaid was on the line," she "stood up for Maine." It's a nice line for a tough reelection fight. There's just one problem: it leaves out the vote that helped the Medicaid cuts pass in the first place.

Collins wants credit for the "no" vote she cast at the very end — after the outcome was already locked in. What her ad doesn't mention is the vote she cast at the beginning, the one that actually mattered.

The vote her ad leaves out

Trump's budget bill — the "One Big Beautiful Bill Act" — cut roughly $1 trillion from Medicaid and health care. Before the Senate could pass it, senators had to agree to take it up. That's called the motion to proceed. If it fails, the bill goes nowhere.

On June 28, 2025, the Senate voted 51–49 on that motion. It was that close. Two Republicans — Rand Paul and Thom Tillis — voted no. If Collins had joined them, the math gets very hard for the bill's backers.

She didn't. Susan Collins voted yes and helped send the bill to the floor.

Her fellow Republicans knew exactly how much that vote was worth. North Dakota Senator John Hoeven called Collins a "team player" who "helped us get on the bill at a time when we needed that help." That's not a Democrat attacking her. That's a Republican thanking her.

The "no" vote came too late to matter

Days later, on final passage, Collins voted no. That's the vote her ad is built around.

But by then it changed nothing. The bill passed the Senate 51–50, with Vice President J.D. Vance breaking the tie. Collins' "no" was the 50th vote against — one short of stopping it, and only cast once it was clear her vote couldn't sink the bill.

This is a pattern with Collins, and it's one we've written about before. As TIME reported, her protest votes are "as strategic as they are symbolic." She votes no when the outcome is already decided — when a no vote lets her look moderate back home without actually stopping anything.

She did the same thing on the committee level. Collins voted to advance Trump's budget bill out of the Senate Appropriations Committee, which she chairs — a bill cutting Medicaid, SNAP, and programs for low-income Mainers — the day after a private equity billionaire gave $2 million to a super PAC supporting her reelection. Then she voted against the final version. Same move: help it along quietly, oppose it loudly at the end.

Why this matters for Maine

This isn't a technicality. Maine is one of the states with the most to lose from these cuts. Roughly 1 in 3 Mainers is on Medicaid or the Children's Health Insurance Program. Rural hospitals across the state depend on those dollars to keep their doors open.

Collins says she fought for rural-hospital protections. She did negotiate for carve-outs — and she lost that fight, then voted to advance the bill anyway. Wanting a better version of a bill that guts Medicaid, and then helping it move forward, is not the same as stopping it.

Here's the honest version of what happened:

• Collins voted yes on the motion to proceed, the vote that put the bill on the floor.
• She voted yes to advance it out of her own committee.
• She voted no on final passage — after it was clear the bill would pass anyway.
• The Medicaid cuts became law.

An ad that tells Mainers she "stood up for Maine" on Medicaid asks them to remember only the last of those four facts.

The bottom line

A campaign ad is supposed to tell voters what a politician did. This one tells them what she wants credit for while hiding what she actually did. When it counted — when her single vote could have kept Trump's budget bill off the Senate floor — Susan Collins voted with her party, and a Republican colleague publicly thanked her for it.

Mainers who lose their health coverage because of this bill won't get to vote "no" once the outcome is already decided. Collins did. She's now running ads hoping they don't notice the difference.

Source

This post is based on reporting by American Journal News (photo: AP), the official U.S. Senate roll-call record for the June 28, 2025 motion to proceed, and the Boston Globe.