The CBO predicts the two amendments that saved the AHCA in the House will upend insurance markets

The nonpartisan Congressional Budget Office released its score of the American Health Care Act on Wednesday, updating its projections to accommodate the version of the bill that passed the House earlier this month. The CBO offered an initial score of the GOP health-care bill in March, after it was first drafted but before it was amended to amass enough Republican votes to pass the lower chamber.

The two major amendments made to the bill during negotiations sought to make the bill more amenable to the far-right Freedom Caucus members, who felt the first draft did not go far enough to repeal ObamaCare, while retaining the support of more moderate Republicans, who worried about constituents reliant on ObamaCare policies.

As a result, the second iteration of the bill included two key changes, delegating certain coverage mandates to states: They would have the option to waive the ObamaCare mandate that insurers cover certain essential health benefits, including maternity care and mental health treatment; and they would have the option to waive the requirement that insurers charge people of the same age the same premiums regardless of health status, also known as "community rating."

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In its updated score Wednesday, the CBO predicted these two waivers would destabilize the insurance market, due to "market responses to decisions by some states to waive [the aforementioned] two provisions of federal law":

The CBO predicted that in states that exercise their waiver right in both cases, young, healthier individuals would opt for insurance plans with lower premiums rather than purchasing plans from insurers that have retained the community-rating provision. When healthier individuals are not required to purchase insurance, or when they can purchase cheaper plans from alternate providers, those insurers providing more comprehensive coverage to sicker or older individuals are forced to charge higher premiums to those individuals to balance their costs.

Overall, the updated CBO score predicted the American Health Care Act would leave 23 million more Americans uninsured by 2026 than ObamaCare, while reducing the federal deficit by $119 billion. Senate Republicans have already set to work overhauling the bill. Read the CBO's full report here.