By Senator Susan Collins

(R-Maine)

By a 5-4 decision, the U.S. Supreme Court ruled to uphold much of the Affordable Care Act, also known as “Obamacare.” I voted against this law, and I continue to believe that President Obama and Congressional Democrats overreached their authority when they enacted this partisan law.

I am concerned that the law ultimately will hurt our senior citizens and health care providers, increase health care costs, impose billions of dollars in new taxes and penalties and greatly expand the role of the federal government. This law will lead to fewer choices and higher insurance costs for many middle-income Americans and most small businesses—the opposite of what real health care reform should do.

The truth is that Congress failed to follow the Hippocratic Oath: “First do no harm.” The Court has decided that the law is constitutional, but that ruling does not make it good policy or affordable.

There can be no question, however, that our nation’s health care system requires substantial reform. A clean decision by the Court to overturn this law would have helped pave the way for Congress to start over in a bipartisan fashion—as we should have from the start—to draft a health care bill that achieves the consensus goals of improving access and quality, providing more choice, containing health care costs, and making health care coverage more affordable for all Americans.

The Supreme Court did overturn part of the law. I agree with the Court’s decision to concur with the 26 states, including Maine, that challenged the healthcare law’s mandate to dramatically expand their Medicaid programs or risk losing their Medicaid funding. Maine already has a generous Medicaid program.

Had the Medicaid mandate been upheld, financially strapped states would have been forced to make draconian cuts in other critically important areas such as transportation, education and many others in order to comply with this expensive federal mandate. Ultimately, this provision was a false promise because it would not have been sustainable.

I am particularly concerned about the impact that the health care law will have on Maine’s small businesses, which are our state’s job creation engine. The law discourages small businesses from hiring new employees and paying them more. It could also lead to onerous financial penalties, even for those small businesses that are struggling to provide health insurance for their employees.

Even where the law tries to help small businesses, it misses the mark. For example, I have long been a proponent of tax credits to help small businesses afford health insurance for their employees. The new credits for small businesses in the health care law, however, are poorly structured. They are phased out in such a way that businesses will actually be penalized when they hire new workers or pay their employees more. Moreover, they are temporary and can only be claimed for two years in the insurance exchanges.

It didn’t have to be this way. The bitter rhetoric and partisan gridlock over the past few years have obscured the very important fact that there are many health care reforms that have overwhelming support in both parties.

In the wake of the Supreme Court’s divided decision on this law, I continue to hope that Congress will work together to change the law substantially not only in response to the Court’s decision but also to respond to the very real health care concerns of the American people as well as the budget realities we face.

Our nation faces overwhelming financial challenges, including a nearly $16 trillion debt, and this health care law will only make avoiding the coming fiscal cliff even more daunting.