The First 100 Days of a Susan Collins Presidency: What the Record Suggests

Hero photo: File:Ceiling, Maine State House, State Street and Capitol Street, Augusta, ME.jpg — via Wikimedia Commons.

01 The scenario

This article asks a hypothetical question: if Susan Collins, the Republican senior senator from Maine, were sworn in as president, what would her first 100 days look like based on the record she has actually built? Collins is not a declared presidential candidate — the research digest for this article records that she is running for re-election to the Senate in 2026 — and this analysis takes no position on her prospects.

What makes Collins a distinctive scenario subject is the office she holds now: chairman of the Senate Appropriations Committee, the post that controls the flow of all twelve federal spending bills. A Collins presidency would arrive with an unusually detailed, insider's view of exactly how the executive branch gets funded. This is a scenario analysis, not a prediction that the person will become president and not an endorsement or criticism of the person.

Her record — a Medicaid-defending vote against her party's signature spending bill, a bipartisan insulin price cap, a shipbuilding and defense-jobs agenda — is the evidence base for what follows. A reasonable inference from these positions is a presidency organized around apprenticeship in the federal budget: practical, program-specific, and slower to embrace structural change than either party's activists would prefer.

02 The record: who Susan Collins is

Susan Collins has represented Maine in the U.S. Senate since 1997 and is in her fifth term. Before the Senate she served in state government — in the Maine departments of Transportation and Insurance — as a New England administrator for the Small Business Administration under President George H.W. Bush, and ran for governor of Maine in 1994 before winning her 1996 Senate race. The research digest notes the Boston Globe's characterization of her as the only GOP senator from a Democratic-leaning state.

She chairs the Senate Appropriations Committee, with particular prominence on the Defense appropriations subcommittee in the 119th Congress, and previously served on the HELP Committee. She is running for re-election in 2026 against Democrat Troy Jackson, a former state Senate president, in a race the digest's source rated a toss-up.

The relevance to a first-100-days scenario is direct: a president who has chaired Appropriations knows precisely which presidential requests require new statute, which require appropriations, and which are simply executive scheduling decisions.

03 Medicaid, rural health, and the OBBBA no vote

Collins's defining 2025 vote was one of the most consequential no votes of the year: she opposed the One Big Beautiful Bill Act on July 1, 2025, one of three Republicans to do so alongside Rand Paul and Thom Tillis; it passed 50-50 with the vice president breaking the tie. Her statement centered on Medicaid: “The Medicaid program has been an important health care safety net for nearly 60 years... Approximately 400,000 Mainers — nearly a third of the state's population — depend on this program.”

The detail matters for a scenario analysis: the digest records that she supports Medicaid work requirements for able-bodied adults not raising young children, caregiving, or in school, but opposed the bill's rural-hospital funding levels and proposed bolstering the $25 billion rural-hospital package. FactCheck.org examined this record in August 2026 in connection with campaign ads about the bill's Medicaid cuts.

The unilateral-versus-congressional split is documented in the digest itself: Medicaid work requirements can be implemented through CMS waiver rules — executive action — while the deeper OBBBA-style restructuring needs statute, which she resisted. A president Collins could adopt the work-requirements version she supports without Congress, and would need Congress for anything beyond that.

04 Drug pricing and the bipartisan health agenda

Collins's highest-visibility 2026 health initiative is a bipartisan bill, unveiled March 25, 2026 with Senators Jeanne Shaheen (D-NH), Raphael Warnock (D-GA), and John Kennedy (R-LA), to cap insulin at $35 per month for all patients regardless of Medicare or Medicaid status. The digest notes the Medicare version of the cap already exists administratively; extending it to commercial plans needs statute.

Her health portfolio in this Congress also includes the Alzheimer's screening-expansion bill (with Cortez Masto, Capito, and Warner), a bipartisan PFAS clinician-care bill with Shaheen introduced January 9, 2026, a disease management and prevention bill with Peters (February 26, 2026), seniors' anti-scam protections, and CFTC whistleblower-program strengthening.

A reasonable inference from these positions is a presidency that pursues health policy through targeted, bipartisan, price-and-access bills rather than structural overhaul — and that would send the insulin cap as an early, easy-to-pass legislative item.

05 Defense, shipbuilding, and immigration funding

As Appropriations chair, Collins has steered defense funding toward Maine shipbuilding: $6.5 million advanced for Portsmouth Naval Shipyard on July 17, 2025, nearly $4 million for Maine Maritime Academy on August 5, 2025, and NDAA provisions she championed. On February 3, 2026 her bill to support shipbuilding, defense manufacturing, and jobs in Maine was signed into law.

The digest draws the unilateral line precisely: shipbuilding funding requires appropriations, but executive scheduling of Navy work can favor particular yards unilaterally. A president Collins could direct the Navy's maintenance and new-construction scheduling toward public shipyards on day one; the money would still run through the committee she used to chair.

On immigration funding, the digest records a split record: she cast what centralmaine.com called a crucial 50-48 vote in favor of the Republican plan to fund ICE and Border Patrol on April 23, 2026 — and separately refused to scrap the filibuster to pass the SAVE America Act, the House-passed voter-ID election bill, while backing the bill itself (Fox News; Newsweek). A June 2026 report that she was one of four Republicans opposing a SAVE Act attachment to an ICE funding bill comes from a partisan outlet (Maine Wire) and is flagged in the digest as needing cross-check before publication; it is treated here as unverified.

06 The appropriations presidency

The appropriations chairmanship is the through-line of any Collins scenario. The digest is explicit: in a first-100-days scenario she is — as chair — the single most important senator for moving or slowing a president's funding requests, including shutdown dynamics. Transposed to the presidency, that experience cuts both ways: she would know precisely how to time requests to the appropriations calendar, and Congress would know she knows.

Her shutdown-era instincts are visible in the July 2025 vote series: she opposed the OBBBA over Medicaid and rural-hospital levels while her proposed amendments failed (the Senate blocked her changes per the Portland Press Herald), and she then voted to fund ICE and Border Patrol in April 2026. That is a pattern of funding-government-first, structurally-cautious behavior.

07 What a Collins first-100-days calendar would test

The documented record lets a first-100-days calendar be sketched in broad strokes. From the digest's own executive-action assessment: CMS work-requirements rules (the version she supports) could be issued early; Navy shipyard scheduling could shift toward public yards; the commercial insulin cap, the Alzheimer's, PFAS, and anti-scam bills, and any rural-hospital funding increase would go to Congress.

What the record suggests most strongly is sequencing discipline: a president who spent 2025 and 2026 introducing bipartisan, narrowly-tailored bills — and who chairs the committee that decides what gets funded — would plausibly open with a small, passable package rather than a structural one. A reasonable inference from these positions is that the insulin cap and rural-hospital provisions lead the legislative calendar, while CMS and Navy scheduling actions lead the unilateral one.

There is not enough public evidence to determine how a Collins administration would handle the levers her record does not document — energy, AI, and trade among them. This would require congressional approval rather than unilateral presidential action for anything beyond the CMS and scheduling levers above.

08 What the record cannot tell us

The record has gaps, and stating them is part of the analysis.

• The claim that Collins was one of four Republicans voting against attaching a SAVE Act version to an ICE funding bill in June 2026 comes from a partisan outlet (Maine Wire) and was not cross-checked against the roll call; it is unverified and excluded from the scenario above.
• Her full 119th-Congress committee assignments beyond the Appropriations chairmanship were not re-verified from her official page this session.
• No recent documented energy or AI position for Collins was found in this research pass. There is not enough public evidence to determine where a Collins administration would start on energy production or AI policy from this record alone.
• Her own agenda items — the insulin cap for commercial plans, the SAVE Act, ICE funding levels — would each require congressional approval rather than unilateral presidential action, as the digest itself notes.