Maine Democratic Senate hopeful Troy Jackson used a televised debate to attack Republican Sen. Susan Collins over Medicaid funding and instead exposed a startling lack of understanding of how the law actually works.
During a debate in Portland, Jackson, who served as Maine Senate president from 2018 to 2024, tried to blame Collins for low Medicaid reimbursement rates, declaring, Sen. Collins just brought up how [Medicaid] reimbursement rates are not high. Shes been in Congress for 30 years. She touts how shes chair of appropriations. Yeah, it would be great if she actually worked on that and got that done, because were not getting enough reimbursement. According to Western Journal, Collins immediately corrected him, turning what Jackson clearly thought was a winning line of attack into a civics lesson that underscored his own confusion about the division of state and federal authority.
Collins responded bluntly, making clear that Jackson was aiming his fire at the wrong target. Medicaid rates are set by the state. They are not set by the federal government. Medicare rates are set by the federal government. So it is Augusta [Maines state capital] that is responsible for the inadequate reimbursements under the Medicaid program, she said, a statement that aligns with federal guidance and basic constitutional principles of federalism.
The Centers for Medicare and Medicaid Services (CMS) explicitly explains that states, not Washington, determine Medicaid reimbursement rates and the scope of covered services. The Medical Assistance (MA) rate is a states standard reimbursement for Medicaid-covered services. Each state sets how it will reimburse Medicaid recipients. For example, some states reimburse for each service provided during an encounter (a face-to-face interaction between the patient and the healthcare provider), rather than setting a flat fee for each encounter, the agencys website notes, underscoring that state policymakers, including Jackson during his leadership tenure, bear direct responsibility for those decisions.
CMS further clarifies that while the federal government establishes broad parameters, the real discretion lies with the states. The amount of money Medicaid reimburses depends on individual state policies and other factors. However, reimbursement rates must fall between the federally established minimum and maximum payment limits, the guidance continues, meaning Washington sets the outer boundaries while state officials choose where to land within them.
In practical terms, that means the federal government picks up a defined share of the cost, and the state decides how generous or stingy to be within those limits. According to the Kaiser Family Foundation, the federal government covers 67 percent of Maines Medicaid expenses, with the state responsible for the remaining 33 percent, a cost-sharing arrangement that is fairly typical and leaves substantial authority and accountability in Augusta.
Collins, a moderate Republican often criticized from the right for her willingness to work across the aisle, used the debate to highlight Jacksons legislative ineffectiveness as well. When given the opportunity to question her opponent directly, she delivered another pointed critique: In your more than 20 years in the legislature, more than one-third of your bills were unanimously rejected in committee. You couldnt even find one Democrat on the committee to support a third of your bills, she said, drawing attention to his inability to build consensus even within his own party.
She then pressed the issue, tying his record in Augusta to what Mainers could expect if he were sent to Washington. If you cant find one person in your own party to vote for your bills when you were the Senate president in Maine, how do you think youre going to get things done in a closely divided Senate as the most junior senator? Collins asked, suggesting that Jacksons style is better suited to partisan posturing than actual lawmaking.
Jackson tried to deflect, claiming that multiple lawmakers often introduce similar bills and that he was a team player willing to let others versions advance. He then pivoted to attacking Collins record, insisting he does not see what legislation she has passed that has been beneficial to the people of Maine, a line that may resonate with progressive activists but ignores her long record of bipartisan deals and targeted relief for rural states.
To bolster his critique, Jackson cited the Big Beautiful Bill and the Iran war as examples of what he portrayed as harmful votes by Collins. But his attack again glossed over key facts, starting with the reality that Collins actually opposed final passage of the Big Beautiful Bill, explaining that she would only support it if $50 billion in funding for rural hospitals were added, a condition that reflected her concern for small-town health care providers rather than blind allegiance to party leadership.
Collins did back a procedural motion that allowed the legislation to be considered on the Senate floor, a common step for senators who want debate and amendments even when they are not prepared to support the final product. From a conservative standpoint, that distinction matters: supporting open debate is not the same as endorsing every line of a massive spending or tax package, and Jacksons attempt to blur that line suggests either political opportunism or a shallow grasp of Senate procedure.
Ironically, many of the Big Beautiful Bills provisions were broadly pro-worker and pro-growth, consistent with a conservative preference for letting Americans keep more of what they earn. The law included no tax on tips, overtime, and Social Security, and increases the standard deduction and child tax credit to $2,200 per child, measures that allowed Mainers to retain more of their paychecks and reduced the federal governments reach into family finances.
On foreign policy, Jackson again mischaracterized Collins record by reducing a complex series of votes on Iran to a simplistic talking point about the Iran war. Collins voted against a War Powers Resolution in March that would have halted U.S. military engagement, but the following month she joined Democrats in a separate effort to push then-President Donald Trump to end the conflict, reflecting a nuanced approach to executive power and military strategy rather than a reflexive hawkish or dovish stance.
That mixed record may frustrate some on the right who prefer a more consistently confrontational posture toward Iran, but it is a far cry from the caricature Jackson attempted to draw. So even Jacksons criticism of Collins record displays an ignorance, willful or otherwise, of her votes, and raises questions about whether he is interested in honest debate or simply parroting talking points crafted to inflame the progressive base.
For Maine voters, the exchange offered a clear contrast between a seasoned senator who understands the mechanics of federalism and legislative process, and a state-level politician who appears more comfortable assigning blame than accepting responsibility for his own role in state policy. On issues from Medicaid reimbursement to tax relief and foreign policy, Collins record may not satisfy every conservative litmus test, but Jacksons misstatements and misfires suggest that sending him to Washington would mean elevating someone who struggles with the basics of the job he is seeking.
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