For the second consecutive week, Taysom Hill looked on helplessly from the sidelines as his Saints team flailed and failed in a blowout loss.
A 31-6 defeat by the Bills marked the Saints' fourth straight loss and a steep fall from a 5-2 start following a season-ending injury to Jameis Winston. But it wasn't a question of whether Trevor Siemian would be replaced at quarterback, because Hill wasn't healthy enough to do it, Saints coach Sean Payton said.
“We knew he wasn’t going to be able to play quarterback this week," the coach said, simply, after the game.

Hill initially injured his foot in a Week 10 loss to the Titans, his first game back from a concussion in Week 5. He was active for the Week 11 loss to the Eagles, but served in the backup QB role. It's a role that would normally be held by another QB, this season either Siemian or Ian Book, and wouldn't land any snaps in the game. With the rookie inactive, it was clear from the start that Hill wouldn't see snaps unless he was brought in as the full-time QB.
Hill was listed on the injury report with that same foot issue, but was a full participant in practice all week. But that designation didn't mean he was ready to play or start, Payton said. He would've been available on an emergency basis and in a limited role. Payton wouldn't address whether changes would be made ahead of a Week 13 matchup with the Dallas Cowboys, but everything is on the table.
Siemian was effective in his first two starts, but the turnovers have crept into his game the past two weeks. The blocking was also a struggle, despite the return of Terron Armstead at left tackle. Without Alvin Kamara or Mark Ingram the Saints couldn't get anything going on the ground. Siemian finished 17-of-29 for 169 yards, 1 TD and 1 interception.
“[Losing] just weighs on you, period," Payton said. "It’s something that obviously we’ve got to look closely at everything we’re doing and who we’re doing it with. And it’s not like new players are going to come walking through the hallways, it’s gotta be from within.”
Even with a losing streak and a 5-6 record, the Saints are still in the thick of the playoff race. They entered the day still in the playoff field, but have now dropped behind the San Francisco 49ers and Minnesota Vikings, both at 5-5.