I am on the East Coast now watching the polticial sausage get made. A deal has been cut with one of two Republican groups opposing the bill. To get support, the bill now provides a $2.3 Billion payoff for Medicaid expansion to upstate New York, and similar payoffs to a handful of other states and districts. But some Republicans are angry at the payoffs, and many do not like the rush to vote because they will not have a chance to see the bill they are voting on. Pundits are saying the bill will pass by a very narrow margin even if many Republicans see it as worse the the original-- it will go to the Senate where more changes are expected.