THE BURNED OVER DISTRICT

And it is the true horror that anyone who actually works and pays taxes could imagine. On the other hand, if your net worth has lots of zeros in it you can expect a yuge gift from the 1%'s Uncle Sugar.

The 142-page bill would create a new system of federal tax credits to help people buy health insurance, while offering states the ability to drop many of the benefits required by the Affordable Care Act, like maternity care, emergency services and mental health treatment.

The Senate bill — once promised as a top-to-bottom revamp of the health bill passed by the House last month — instead maintains its structure, with modest adjustments. The Senate version is, in some respects, more moderate than the House bill, offering more financial assistance to some lower-income people to help them defray the rapidly rising cost of private health insurance.

But the Senate measure, like the House bill, would phase out the extra money that the federal government has provided to states as an incentive to expand eligibility for Medicaid. And like the House measure, it would put the entire Medicaid program on a budget, ending the open-ended entitlement that now exists.

It would also repeal virtually all the tax increases imposed by the Affordable Care Act to pay for itself, in effect handing a broad tax cut to the affluent, paid for by billions of dollars sliced from Medicaid, a health care program that serves one in five Americans, not only the poor but almost two-thirds of those in nursing homes. The bill, drafted in secret, is likely to come to the Senate floor next week, and could come to a vote after 20 hours of debate.

So the takeaway on this bill is what it takes away. It takes away any support for people who can't otherwise pay for health insurance, the cost of which will go up in the bill. It also takes away to annoying taxes which kept obscenely rich people from getting just a wee bit richer. And it takes away any prospect of economic revival ans it guts approximately 1/6 of the economy which will not be replaced by spending by the 'wee bit richer' because they never do. In spite of all that Mitch's Monster already has one Republican opponent.

Mr. McConnell faces a great challenge in amassing the votes to win Senate approval of the bill, which Republicans are trying to pass using special budget rules that will allow them to avoid a Democratic filibuster. But with only 52 seats, Mr. McConnell can afford to lose only two Republicans, with Vice President Mike Pence breaking the tie. He may have already lost one — Senator Rand Paul, Republican of Kentucky, has indicated repeatedly that the bill is too liberal for him.

Imagine that! Too liberal, and from a doctor, no less.