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clawhammer
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Please assist with the explanation. Is it because the the use of 'may' is required to keep original meaning?

We should eliminate answers B and E." ... that ..., and that ..."
There is the contrast between the two main clauses. Therefore, we need conjunction here that puts emphasis on the contrast."Agreement exists among professional sports leagues that,... and that ..., there is no consensus on the best course of action"
That is actually a very very good point Brian. I have noticed that sometimes we start by looking for small things and completely ignore the obvious ones.Brian@VeritasPrep wrote:Hey guys,
It seems like you're all on the same (and correct!) page here, but I saw the title of the post and had to chime in. Just looking at the title, "even though vs. although", I knew before looking at the sentence that that difference would be a smokescreen.
Before you consider idiomatic differences (although vs. even though; instead of vs. rather than; etc.), try to find major, recurring themes (subject-verb agreement, sentence structure, etc.), as those are much easier decisions to make, and overwhelmingly they'll allow you to avoid making those "which sounds better" decisions that are much lower percentage for you.
Here, it comes down to the fact that the sentence requires "that" - Leagues may agree THAT (to set up a new subject of a new clause) steroid use...
Go for the higher-percentage decisions first that you know you're responsible for, and save the tedious, obscure decisions for later!