Despite President Donald Trump’s assertion that a new GOP health care bill is “mean,” not much is known about the proposed legislation, set for a vote next week.

The bill would repeal huge portions of the Affordable Care Act, potentially hiking premiums for the elderly, slashing Medicaid spending and kicking millions off of their insurance plans — but with no legislative drafting sessions, no town halls, and no committee hearings, Democrats (and some Republicans) are finding themselves totally shut out of a process shrouded in mystery.

Republican senators only need 51 votes to pass the bill, under Senate rules. But can they do it?

“There’s still a fairly good chance that this thing flounders before the Senate does anything,” medical ethicist Art Caplan said in an interview Tuesday with Boston Public Radio. “This secrecy climate that they’ve created, it is mean … and I don’t know that it’s going to get out of there.”

According to Caplan, a special election Tuesday between Karen Handel and Jon Ossoff in Georgia’s Sixth Congressional District might be the deciding factor in the fate of the GOP healthcare bill. If Ossoff, a Democrat, wins the seat vacated by Health and Human Services Secretary Tom Price in a traditionally conservative district, that might send the message to Republicans in the Senate that the public is not behind their bill.

“If [Ossoff] wins, I think this bill won’t pass, because it will frighten Senate Republicans and other legislators who are kind of vulnerable in the next election,” Caplan said. “If the Democrats score an upset in the district that Tom Price came from, I think that’s the signal that this thing won’t go.”

Though the contents of the bill are still (officially) unknown, a few rumors about the potential features have been swirling around. “There are a couple of features of the bill that we believe are in there — they’re certainly in the House version — that are particularly horrible,” Caplan said. “One is Medicaid cuts. The way we used to do it … the way it was done under the Affordable Care Act, and actually before that, was to give block grants to states. The Republican bill apparently says to give payments-per-capita. That means that there’s going to be less flexibility, if you will, for states to move money around, and to figure out whether they want to do something about the opioid epidemic, or if they have other problems that are bigger, because they’re getting a rate based on a per-head basis. It just means a cut de facto in what they’ve got to use.

“They’re also lobbing out the rate at which payments will escalate … they’re not linking it to healthcare costs, they’re linking it to general economic indicators,” Caplan continued. “It means a return to the bad old days when people who are poor don’t get healthcare to try and maintain or anticipate some kind of a problem, and then they wind up at the emergency room with a really bad problem that’s very expensive to do something about, and we all wind up paying anyway.”

Republican senators say they expect to see the bill by the end of this week.

To hear Dr. Art Caplan’s full interview with Boston Public Radio, click on the audio player above.