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WASHINGTON (CBSMiami) – The latest Republican effort to repeal and replace the Affordable Health Care Act appears to have been dealt it’s final blow.

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Maine Sen. Susan Collins attributed her decision to vote “no” on the Graham-Cassidy health care bill to the partial score released by the Congressional Budget Office (CBO) late Monday afternoon.

“It found, as I suspected would be the case, that it would have a negative impact on millions of Americans who are now insured, so it was the final piece of the puzzle that I had been waiting to confirm, Collins told reporters outside her Senate office. “It was clear to me that the Graham Cassidy was not the answer.”

Earlier in the day, Kentucky Sen. Rand Paul announced he will not vote for the latest version of the Republican health care bill, calling last-minute changes designed to send more money to states with undecided senators as “suspicious.”

Paul told reporters after an event in his home state he still plans to vote against the Republican bill that would repeal former President Barack Obama’s health care law. He says that’s because instead of significant spending cuts, it redistributes money to states based on a formula.

Lawmakers over the weekend tweaked the bill to give more money to states including Alaska, Arizona, Maine and Kentucky. Those are all states where senators have indicated their opposition to the bill. Paul called that tactic a “formula food fight” and said it was not the right way to get votes.

Sen. Kirsten Gillibrand also called the Graham-Cassidy bill “not only immoral but insulting.”

The bill is the latest effort by GOP senators to scrap the Affordable Care Act, but has received lack luster support from even Republicans.

The bill would repeal much of the ACA and give states the power to ease requirements on the law’s mandates, including prohibiting insurers from charging higher premiums for the seriously ill.

Arizona Sen. John McCain said over the weekend he can’t vote for the current version. He said the process is already too rushed and Paul says it’s too expensive.

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“I think what it sets up is a perpetual food fight over the formula, what happens when the Democrats win, they’re gonna try to claw back that money from Republican states and give it to Democratic states.”

The bill takes most Obamacare funding and turns it over to states to develop their own plans. The new version delivers more funding to states like Arizona, Alaska and Maine, where GOP senators are holding out.

There’s a rush for the vote because of a rule, that allows the legislation to pass with just a simple 51-vote majority, which expires on Saturday. After that, it will take at least 60 votes.

Sen. Ted Cruz had also said he was currently a “no vote,” and there are no Democrats who have said they would support the measure.

All Democrats are expected to vote against the plan and a growing number of Americans are opposed.

Protesters have gathers outside of the hearing room where the Senate Finance Committee is holding a hearing on the health care bill on Monday afternoon.

Alisa Grishman manages several health conditions, including multiple sclerosis. She calls the healthcare bill a life or death sentence.

“My life is on the balance on this. And if this bill goes through,that’s it,” said Grishman.

A new CBS News poll reveals just 20-percent are in favor of the bill, while 52-percent disapprove.

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The last attempt to repeal Obamacare fell just one vote short in July.