More generally, the bill is structured so that essential coverage provisions can be dropped, and insurers will be able to offer barebones plans with low premiums—and sky-high deductibles, far greater than those imposed by plans on the Affordable Care Act exchanges. Many people could have insurance that would be faux-insurance, something appearing great until they actually needed it, and discover that their ailment, or pregnancy, was not covered, or if it was, requires them to pay $7,500 out of pocket before it pays a dime.

Those are just a few entries in the parade of horribles in a bill written in secret by a handful of staff without input from providers, patients, the committees that know health policy, or nearly all senators of both parties. Of course, a major reason for that unprecedented process was that the bill is more about tax policy than health policy.

The big tax reform will have to wait for another budget resolution and another reconciliation bill. But without this “health” bill, a massive tax cut under the guise of tax reform faces an almost insurmountable obstacle—the requirement that it not increase deficits or debt after a 10-year window. That is why getting a health bill that provides half the desired tax cuts and has them paid for by Medicaid cuts is so important for McConnell and his allies.

To be sure, the McConnell bill looks to be in desperate straits. With 52 Republicans in the Senate, McConnell can only lose two and still rely on a vice presidential tie-breaking vote to put the bill over the top. Already, though, there are five announced “No” votes, including four arch-rightists (Rand Paul, Ron Johnson, Ted Cruz and Mike Lee) and the not-quite so-radical Dean Heller. And there are numerous others, including Susan Collins, Bill Cassidy, Joni Ernst, Bob Corker, Lisa Murkowski and John McCain, who have complained openly about the secret process or fretted about the vulnerability of their constituents on Medicaid.

So why do I think this bill could well pass? First, remember that when a senator says he or she is opposed to the bill “in its current form,” that is code for, “change the current form, and I may no longer be opposed.” For an individual senator, this gives double cover. You can show your independence and mollify skeptical voters—and then proudly declare victory, that you have protected those voters, when you succeed in winning a concession.

McConnell knows this, and that is why the “draft” bill that emerged earlier this week was in many ways both tougher and weaker than observers expected. The bill was projected to phase out the Medicaid expansion with a seven-year window, compared to the three years of the House bill; it had a five-year phase out. The bill was supposed to protect states like Ohio and West Virginia with serious opioid epidemics that have expanded Medicaid; instead it provided a paltry $2 billion cushion. And the bill protected other parts of Obamacare, providing, for example, more support for poor and older individuals than the House bill.