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By Andrew Stanton
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Incumbent Susan Collins and Troy Jackson face a tight race for U.S. Senate in Maine as the state’s healthcare system is under duress ahead of Tuesday's midterm elections.
Healthcare has become a major dividing line between Collins, a moderate Republican, and Jackson, a progressive Democrat, in what is expected to be one of the nation's closest contests on November 3.
It’s a major issue for voters in Maine, where the closures of rural maternity wards, consolidation of hospitals and cuts to Medicaid could upend a medical system that is already under pressure. Maine also has one of the oldest populations in the country, so programs like Medicare are important to many voters.
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Newsweek reached out to the Collins and Jackson campaigns for comment via email.
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Why Maine Senate Race Is Important in the Midterm Elections
Maine’s race remains one of the most important of the midterms for Senate control. Republicans hold a 53-47 majority, so Democrats need to flip a net four seats to win control of the chamber, as Vice President JD Vance would serve as the tiebreaking vote in the event of a tie.
Democrats have viewed Maine as one of their top opportunities to flip a seat this year, as it is a left-leaning state that President Donald Trump lost in all three of his presidential runs, including by 7 percentage points in 2024. Trump’s popularity has fallen since then amid voter frustration with the state of the economy, giving Democrats hopes that Collins may be more vulnerable this year.
But Collins is still seen as a formidable opponent, and polls point to a close race. Collins’ personal popularity and bipartisan image has helped her defy partisanship in the past, and she has touted her status as the chair of the Appropriations Committee on the campaign trail as a boon for the state, including its rural healthcare system.
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Maine’s Fragile Healthcare System Under Duress
Maine has faced a rural healthcare crisis, with 11 of the state’s 23 maternity wards closing in the past decade, and a planned closure of a birthing unit in Damariscotta in December could add to that strain.
Major networks across the state have also been grappling with a difficult environment and consolidation. For instance, York Hospital this month was absorbed into MaineHealth. Northern Lights Health, another provider, has also dealt with years of financial turmoil and has had to close facilities.
Work requirements passed as part of the One Big Beautiful Bill Act (OBBBA) in 2025 could also result in Mainers losing coverage, critics warned. The Maine Center for Economic Policy found in a September report that around 29,000 Mainers could lose MaineCare coverage as a result.
Those Medicaid changes have become a major issue on the campaign trail.
Jackson has criticized Collins over the bill. Although she ultimately voted against the OBBBA, Jackson and Democrats have noted that she voted to advance the legislation on procedural votes, helping to secure its ultimate passage.
“Senator Collins, Mainers aren’t stupid. You could've voted to stop Trump’s $990 billion Medicaid cuts in their tracks. Instead, you voted to advance them to the Senate floor,” Jackson wrote in a July 16 post on X.
Collins has said that her opposition to the bill was tied to the Medicaid cuts. In a July 2025 statement, she said the program has been an “important health care safety net for nearly 60 years that has helped people in difficult financial circumstances, including people with disabilities, children, seniors, and low-income families.
“I am pleased that the bill contains a special fund that I proposed to provide some assistance to our rural hospitals, but it is not sufficient to offset the other changes in the Medicaid system. While I continue to support the tax relief I voted for in 2017, I could not support these Medicaid changes and other issues.”
Susan Collins, Troy Jackson Healthcare Policies Compared
Jackson has said Medicare for All would be a top priority in the Senate. He said during a recent interview on CNN’s State of the Union that under his proposed system, it should cover everyone on basic healthcare but that he would support private insurance for elective surgery*.*
“Whenever we have tried to do this, is, like, everyone has to get into the plan," Jackson said. "I mean, I think the controversy over this is that the health care industry, big pharma has made people feel like they're not going to get as good a coverage, you will be getting something less than. But I actually see a scenario where this is going to be great coverage. You will have eye, ear, dental. You won't have to pay the obscene co-pays and things like that.”
Collins has opposed Medicare for All, saying it is too expensive.
She has touted her record on increasing funding for research into diseases like diabetes and Alzheimer’s. During a debate against Jackson, Collins pointed to her ability to bring funds into the state to help support rural hospitals.
“What we don’t need is for big government to take over healthcare, to abolish private insurance that people such as the workers at Bath Iron Works are happy with and that have led to avoidable deaths, 16,000 in England alone, because they couldn’t get care,” Collins said.
Collins voted against the repeal of the Affordable Care Act during Trump’s first term in office.
Susan Collins vs. Troy Jackson: Latest Polls
Recent polling underscores how competitive the race is.
A CNN/SSRS poll gave Jackson a 4-point lead over Collins, 49 percent to 45 percent, among 783 likely voters. It was conducted October 20-26 and had a margin of error of plus or minus 4.5 percentage points.
Jackson held a 2-point lead, 49 percent to 47 percent, among likely voters in a Marist University poll. It was conducted October 22-25 among 1,449 registered voters and had a margin of error of plus or minus 6.6 percentage points.
Jackson also led 49 percent to 47 percent in a Suffolk University poll that surveyed 500 Maine voters October 8-11 and had a margin of error of plus or minus 4.4 percentage points.
Forecasters like the Cook Political Report and Sabato’s Crystal Ball classify the race as a toss-up. Prediction markets give Jackson an edge. He held a 68 percent chance on Kalshi and a 69 percent chance on Polymarket on Friday morning.
Prediction markets allow traders to buy and sell contracts tied to political outcomes and current events, aggregating real‑money wagers into probability estimates.
Prices fluctuate as traders react to polling, fundraising, candidate developments and broader political trends. They measure trader sentiment at a given moment but do not always accurately predict the future.
Maine Voting: What to Know
Polling locations are open from 6 a.m. or 10 a.m. to 8 p.m., depending on a town’s population.
As of Monday, 313,611 absentee ballots had been requested and 275,563 had been returned and accepted, according to data from Maine's Secretary of State office.
Contact Newsweek editors on this story: Jenna deJong and Dave Siminoff.
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