As details become available on the odd mix of compromises required to buy the votes of key senators, it becomes clear that the time line which has been the driver of this process is viewed in terms of days to weeks, not years to decades. There is essentially no priority on creating an sort of workable system in the long term.
How else can one view the incorporation of the provisions to provide specific sweetheart deals for specific states. There is a certain irony that Nebraska, a state whose motto is "Equality before the law", gets a deal whereby the rest of the country picks up the tab for the expanded Medicaid mandate. Who can or will be held to this promise? How in the world can this be constitutional? Why not just have income taxes accrue to those who live in states who voted against you if you have the votes to pull this off?
The odd and unjustifiable preferences go on and on. There is an excise tax on "lavish" plans except for 17 states (I wonder how many have democratic senators?). Is there a precedent for federal taxes levied only on selected states? Hawaii gets a pass on all of this. How does that work?
Medicare advantage is going away...sort of. However, Florida residents as well as some individuals in Pennsylvania, New York, and Oregon will be grandfathered out of being impacted by these cuts. What about equal protection under the law? Is this a dead concept?
I can't help but think of George Orwell's Animal farm. Everyone is equal but some are more equal than others. Harry Reid believes it is all about compromise. I am not sure that he entirely understands just what he is compromising. Perhaps he does.