If I had more time, this would be a long post. But I can only spank boiled ire down on the page for a short time today. A bill developed in secret with “screw you” core elements is not dead yet. It needs to be. Wrongly labeled “better care,” the only healthy improvement it contains is wealthy peoples’ income from tax breaks. The rest of us will suffer. This bill will take health care away from tens of millions, give generous tax breaks to the wealthy, cause major economic hits to great swaths of society, and is opposed by most Americans. It is also opposed by the health care community (from big insurers to hospitals and medical associations), by the AARP, and a long list of other groups. It has an approval rating among the public of just 17%. It’s the least popular legislation in 30 years (and has gotten less popular since this article appeared).

It is amazing that such a terrible piece of legislation is alive at all. Republicans developed it in secret and are trying to ram it down our throats. Conveniently, we are distracted by the Trump circus. Call your senators and encourage them to vote against it (or thank them if they are already committed to doing so).

Don’t be confused by the uncertainty regarding details of this legislation—there is nothing good on the table, just different flavors of really bad. This is purely a party-before-country ideological march over a cliff, for which tens of millions of Americans will suffer immediately (health-wise and economically) and more over the longer term. Here are some of the general outcomes.

Here are details on the bill’s effects. And here is Alaska as an example.

The way to move forward is simple and most agree on it: “Nearly everyone wants changes to the Obama law, while hardly anyone wants to see it abolished without a substitute in place.” Eleven governors (bipartisan) sent a letter to Congress to advocate for this approach.

Here are several data-driven perspectives on the negative effects, including on the nation’s employment. Oh (from the same source), do you get your insurance from your employer? You get to take a big hit, too: “…the legislation would also bring back annual and lifetime limits in employer plans, end the penalty for companies that don’t provide health insurance to their workers, and allow employers to shift much of the cost of copays, deductibles and coinsurance onto their workers.”

They have no idea what they are doing right now in the Senate—it’s just different flavors of really bad. Here’s a current rundown on the juggling act to try to get votes. (None of this revolves around the merits of the bill, only what’s wrong with it!)

McConnell freed up time and has money to spend to try to cajole the recalcitrant (see, for example, the “Kodiak kickback” designed to win over Alaska Senator Lisa Murkowski—it doesn’t cover what’s removed, though). One unforeseen problem, however, is that the Senate parliamentarian says that at least some of these provisions are not allowed under Senate rules.

Here is a more substantive article on the four different bills being floated. Here is another (quite a bit of overlap). Here’s more on the political jockeying that’s preventing this from dying (and why it’s so important to call your senators).

So call your senators, and call them again. Get ‘em focused on fixing things instead of breaking them.

Meanwhile, the rest of the developed world has gotten this down. They pay less per capita and are healthier (and live longer) than we do. See Fig. 6 from this Lancet article. Why can’t we have what they’re having?

Busse et al. (2017), Lancet, Fig. 6.

Footnote: How, you might wonder, did this bill get such a poor acronym as BCRA? I don’t know. Maybe because there were no women on the committee that drafted it. I thought most people knew that BRCA is the name of key breast cancer genes. So we have a dyslexic version of BRCA as a massively shitty bill.

23 July update from Associated Press.

24 July update from Vox.

25 July update from the Alaska Dispatch News. Motion to proceed passed 51-50. Pence had to make the tie-breaking vote, with Collins & Murkowski voting against it with all 48 Democrats. There is absolutely nothing on the table that isn’t detrimental to Alaskans, so good on Murkowski. The BCRA itself then died a swift death 43:57, with nine Republicans joining all Democrats in opposing it. Those nine, per Matt Fuller on Twitter (@MEPFuller), were: “Nine Republicans voting no at this point on BCRA: Collins, Cotton, Corker, Graham, Heller, Lee, Moran, Murkowski, and Paul.” The process going forward now is nothing less than a total mess, with no clear bill to vote on and no outcome on the table that doesn’t take away health care from many millions and cause dramatic insurance cost increases among large swaths of society.

25 July update, continued. Fivethirtyeight is carrying ongoing coverage.

Given that the BCRA is now dead, I’ll carry this over into a new post.

Time to re-up this now-classic image: