Americans are finally getting a look at the much-anticipated, heretofore-secret Senate Republican health care bill. As expected, the bill released Thursday amounts to a massive rollback of the federal commitment to promote health care access and would instead pay for hundreds of billions of dollars in tax cuts for corporations and the wealthy.

The Congressional Budget Office isnt expected to weigh in on the Senate bill, dubbed the Better Care Reconciliation Act , until next week. That means theres no official accounting of what the legislation would do to the health care system, how many people stand to lose their coverage and how much the federal government would spend on health care programs. And the 142-page bill consists of complex legislative language that will require days for other analysts to fully digest.

But the plain truth already is clear: This legislation would result in millions of people losing their health benefits and would shrink the safety net over time. Wealthy people and health care companies would see their taxes go down. And although some consumers may pay less for insurance, an untold number of people wouldnt have access to the coverage and medical services they have under the existing health care law.

Senate Majority Leader Mitch McConnell (R-Ky.) hasnt locked down the 50 votes he needs to pass this bill. But GOP lawmakers have been promising Obamacare repeal for more than seven years, President Donald Trump is eager to fulfill his campaign promise to undo the law (if not his vow to replace it with something terrific ) and the House has already advanced its own bill.

McConnell wants the Senate to vote on this bill next week, capping off a remarkably secretive and rapid process that has outraged Senate Democrats .

Although Trump, McConnell, House Speaker Paul Ryan (R-Wis.) and other GOP leaders always refer to their plans as a mission to repeal and replace the Affordable Care Act, the legislation unveiled Thursday is actually a fundamental, drastic overhaul of the Medicaid program that serves children, people living near or below the poverty level, pregnant women, people with disabilities and elderly nursing home residents.

The bill would also eradicate central components of the Affordable Care Act, such as its expansion to Medicaid to cover more poor, working-age adults, its requirement that most people either obtain health coverage or face a tax penalty and its rule that large employers must offer health benefits to workers.

What The Bill Means For Medicaid

Like the House, the Senate seeks to go far beyond unraveling President Barack Obama s landmark 2010 health care reform initiative by making draconian cuts to Medicaid.

The CBO determined that the House-passed American Health Care Act would mean 23 million fewer Americans having health coverage over the coming decade, while a small but very wealthy group of Americans would get a substantial tax cut.

Broadly speaking, the Senate bill looks a lot like that House bill . It calls for rolling back the Medicaid expansion and fundamentally changing the program going forward specifically, by ending the federal governments open-ended commitment to funding the program at whatever levels it takes to cover everybody who becomes eligible. Instead, states would receive a lump sum per year or a lump sum per enrollee.

Projections have shown that the federal government would spend far less on Medicaid spending over time. This would almost certainly force states which jointly fund and operate Medicaid to make deep cuts to the program by taking actions like eliminating coverage and benefits and reducing already-low fees to doctors and other medical providers.

Republicans have said their reforms would protect the most vulnerable people in Medicaid, such as the elderly and disabled, because the formula for the new spending caps assume greater spending on these people. But experts who have analyzed the proposals have said states would still have a relatively free hand on how to spend that money once they get it from Washington. Because the elderly and disabled account for half of program spending, coverage for them would be ripe targets for cuts.

The CBO projected 14 million fewer people would receive Medicaid over the next 10 years under the House bill, and the Senates deeper cuts to the program could mean an even higher number losing this coverage.