REUTERS/Joshua Roberts

The first glimpse of the Senate health care bill, which has been shrouded in secrecy, shows that it is every bit as bad as most Americans have feared.

Senator Mitch McConnell is scheduled to brief Senate Republicans tomorrow on the contents of the long-awaited TrumpCare bill, created to replace Obamacare (the Affordable Healthcare Act) –  but the first details have been obtained by the press.

The bill being proposed by the Senate after weeks of highly secret closed door meetings would cut Medicaid expansion at a slow rate than what the House bill passed last month proposed, but ultimately it would enact even deeper cut to the program for low-income Americans, according to the Washington Post.

The draft, which is subject to additional changes, would repeal all of the ObamaCare taxes except the so-called “Cadillac tax,” which covers high-cost health plans. This will please conservatives because the Senators had considered keeping some of the ObamaCare taxes.

In another change from the House version, the eligibility will be tied to the income level of the person, not to their age. This is expected to make it easier for many low-income people to continue to qualify for subsidies, which could cut the number of Americans who will lose coverage.

The Senate version will give individual states even wider latitude in opting out of the Obamacare regulations, which is bad news for those in “red” states where the ability to get subsidies is tied to how the states participate in the plan.

As expected, the Senate version will cut off all funding for Planned Parenthood, and will also remove language that would have restricted health plans from covering abortions.

This change in abortion language was made so that the bill will more closely reflect the House version, which is important because the Republicans are planning a vote based on an arcane Senate rules that require no big changes from the House version.

This arcane rule will allow Republicans to get approval with 51 votes, a simple majority, rather than the 60 votes needed if it were a significantly different bill. The 60 votes rule would require Democrats to join in approval, which is not realistic.

Democrats are angry about the repeal of Obamacare and don’t approve of the Republican changes or their version of the health care bill. The Congressional Budget Office analysis of the House version estimated at least 23 million Americans will lose coverage if it is passed.

There is much in the bill for conservative and moderate Republicans to still disagree on so it is no sure thing there will be the requisite 50 votes for passage.

However, McConnell has shown in the past an ability to herd all the differing factions to get what he needs, so passage within the next two weeks remains viable, despite the anger it will generate from Democrats and many Americans.

The Republican bill will make it more difficult for many people to get health insurance, and it remains unclear if the Obamacare rules that forced insurance companies to accept patients with pre-conditions will remain in force. If it does continue that, it will be more difficult and expensive for those who do participate in any case.

There are also question yet to be answered including whether the millions of Americans who get coverage from employers will not face caps on how much they can receive if they get sick.

The Republicans may finally keep their promise to kill the highly popular ObamaCare but in the process, they are giving Democrats a powerful weapon to use in the 2018 midterm elections to encourage voters to punish the party that took away the best parts of their health coverage.

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