The bill, which was marketed as different from the health care legislation passed by the House in May, looks remarkably similar to its predecessor. It’s also complex and hard to understand.

Here’s a breakdown of everything you need to know before the bill comes to a vote, as soon as next week: 

As expected, the bill released Thursday amounts to a massive rollback of the federal commitment to promote health care access and would instead pay for hundreds of billions of dollars in tax cuts for corporations and the wealthy.

The Senate bill does not include some of the particularly harsh aspects of the House legislation, including a provision that would let states end protections for people with pre-existing conditions.

A one time fund of $2 billion for addiction and mental health treatment “is pocket change” said Keith Humphreys, professor of psychiatry and behavioral sciences at Stanford University.

The Senate bill also slows the introduction of these Medicaid cuts, pushing the deepest wounds to the elderly into the future. The changes won’t fully kick in for seven years, which of course is long after the next Senate election. But make no mistake, said advocates for the elderly: When these changes to Medicaid fully kick in, they will pack a wallop.

Slashing Medicaid and blocking millions of women from getting preventive care at Planned Parenthood is beyond heartless. One in five women in this country rely on Planned Parenthood for care, said Cecile Richards, president of Planned Parenthood.

Reproductive rights advocacy groups like the Center for Reproductive Rights and Planned Parenthood have pounced on a section of the bill that they say makes it possible for states to basically force some women to go back to work two months after they give birth, at which point many moms are still healing and all parents are very much in the thick of caring for a needy, helpless newborn. 

Medicaid is the single largest payer of mental health services in the country. This could potentially leave millions of Americans without coverage that could help them get the care they need, like therapy, for mental health issues.

This is what’s known in the insurance business as a “death spiral”: more and more expensive customers with fewer and fewer healthy ones in any given year to cover the costs. Republicans are fond of falsely saying the Obamacare markets are in this state ― and, however troubled they are, there’s no death spiral ― but their bill is designed to create the exact conditions that cause one.

Without insurance, insulin refills alone costs one diabetic patient $225 every three weeks. The father rationed his medication, choosing to buy diapers, food, and milk for his son first. He ended up in the emergency room over and over again, racking up tens of thousands of dollars in medical bills he had no way to pay on his salary.  

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