As the Senate inches obstinately closer to passing a bill that would endanger health care coverage for millions, many questions remain. How many people would the Cassidy-Graham plan leave uninsured? What would happen to people who live in states that allow insurers to charge people more if they have a pre-existing condition? What about women? Do they count as people under this plan? Why not wait to vote until a CBO score gives people a sense of what the plan would do?

But the most glaring question about the Cassidy-Graham health reform bill is: Why?

Jimmy Kimmel—of all people!—has demonstrated more mastery of what’s actually contained in the bill than its sponsors, using his late-night monologues this week to run circles around Louisiana Republican Bill Cassidy. During one of his monologues, the comedian pointed out that the bill is about as popular in the states as Vladimir Putin, so the Senators who are planning on voting in favor of it can’t be doing it to appease the public.

There is no CBO score yet and won’t be until next week, so those who have decided it’s a good bill can’t have made that decision because they have seen analysis concluding as much. They haven’t.

The bill itself would allow individual states to exempt insurers from protections the Affordable Care Act established, consumer protections that required insurers to cover certain essential health benefits (like gynecological care), which could leave millions vulnerable to prices so prohibitively high they opt out of insurance entirely. For that reason, Cassidy-Graham’s supporters can’t be on board because it would give people better access to better health care. It doesn’t.

The insurance industry, doctor groups, patient groups, and health care watchdogs all hate the bill, so those supporting it can’t be doing so because they’re capitulating to the opinions of moneyed experts. They’re not.

So, why? Why do this?

Vox’s Jeff Stein caught up with several Republican senators and asked what the bill does, and their answers were idiotic and maddening. Kansas Republican Pat Roberts gave an answer so stupid that if a Miss Teen USA contestant had given it onstage, the moment would have gone viral like, such as. Ted Cruz emitted a string of meaningless slime. Oklahoma’s Jim Inhofe repeated a baseless assertion over and over. Chuck Grassley admitted that they were doing this because they’d promised to repeal Obamacare, they’d promised their constituents, and now by gum they were going to do it.

If any of these men had any real empathy, the bill would give them pause. But they don’t, because nothing the bill could do is real to them. None of them are going to ever be pregnant, medical breakthrough notwithstanding (although even if they could, something tells me they wouldn’t.) None of them will ever want an abortion, or long term birth control. It doesn’t occur to them to even think of what that would be like, because it’s not something that could directly impact them. Their cushy congressional benefits package won’t get dinged when a state decides to make it so expensive for somebody with cystic fibrosis to afford insurance that their entire family is driven into poverty. They’re not going to have to deal with any of this.

Why would they worry about any of this? It’s not them!

In the Vox piece, Senator Richard Shelby of Alabama alluded to this shared mindset of a selfish five-year-old so many in government seem to espouse. When asked about how the Cassidy-Graham plan, he made sure to point out that while other states will experience huge cuts in federal aid, Alabama won’t. Like that somehow makes what the bill could mean better.

Meanwhile, Health and Human Services Secretary and serial self-enricher Tom Price flies across the country in a private jet. He’s too busy, according to a rep. Too busy preparing to have a much smaller job, I suppose.

The state of Cassidy-Graham in the Senate speaks to a lack of empathy that people more than a day’s drive from Washington can sense. It’s not that Senators can’t care, it’s that it never occurs to them to care in any real sense. Family-sized tragedies in the rest of the country—financial ruin, the drudgery and pain of living with a terminal illness, the maddening struggle to pay for the ability to stay alive, the decision whether or not it’s possible to afford to have a child, the hopeless ebbing of the accomplishments of one’s parents and grandparents as medical bills pile up—don’t matter to them because they’re as real as an explosion in a Michael Bay movie. They’ll be fine. They’re not cutting Alabama. The pain of real humans registers as moving pictures.

How else can a person justify even risking the pain that Cassidy-Graham might cause in the name of a win?