Sen. Susan Collins’ hypocritical “no” votes on Republican health care reform proposals threaten to cause harm to the very people whom she purports to represent and care about. She was applauded for initially seeing the defects in and voting against the Affordable Care Act. Her current stance almost ensures that reforms will not occur and we will be left with the unsustainable status quo.

The status quo means that the underlying cost of health care will remain unaffordable. The Affordable Care Act will continue to implode on its defects. Medicaid, which cost $574.2 billion in 2016, is no longer the safety net program it was designed to be. Medicaid is a pay-as-you-go program that cannot be sustained, as expanded under the ACA, and the neediest are likely, once again, to fall between the cracks.

The status quo also means that entitlements will not be addressed in any effective manner. Medicare has $48 trillion in unfunded liabilities, and according to Cato Institute economist Michael Tanner, this figure could grow to $88 trillion if we return to double-digit inflation in the cost of health care.

Social Security also has $24.9 trillion in unfunded liabilities. While the Social Security and Medicare liabilities are not officially guaranteed benefits, they are promises that have been made for years by our elected representatives.

The more Mainers and Americans rely on these programs being in place, the more disappointment and harm they will ultimately encounter when the programs collapse. Our national debt is currently over $20 trillion. The Congressional Budget Office projects this to increase to $30 trillion by the end of 2027. Annual federal revenues of approximately $3.2 trillion pale in comparison to the unfunded promises already made. Where is the money to come from? The combined net worth of the “rich” is nowhere near enough to pay for these programs.

John A. Currie, CLU, CEBS