all this? is crap. These things indeed did exist in the bill - they were buy-offs to democrat senators to get them to vote for this hunk of junk. The Louisiana Purchase and the Cornhusker Kickback weren't to Republicans. They were to Democrats. Not a single Republican got concessions because not a single Republican voted for this disaster of a piece of legislation.allow states to opt out of the program; commit $50 million to fund state initiatives designed to reduce medical malpractice costs; allow undercover investigations of health care providers receiving Medicare, Medicaid and other federal programs; and to boost Medicaid reimbursements to doctors in certain states.