Leaders are still waiting for the Congressional Budget Office to produce an analysis determining the budgetary and coverage impact of the Cruz amendment, but some aides said they worry the outcome could be devastating to the overall savings in the bill.
Douglas Holtz-Eakin, a former CBO director, said it appears that Cruzs amendment would send all of the young, healthy people who are cheaper to cover into one insurance pool and leave sicker, older people in a glorified high-risk pool.
It would be expensive and possibly not particularly stable, Holtz-Eakin said in an interview. If the public-policy goal is to give people access to affordable insurance options, theres a set of people who would just not have access to that.
Holtz-Eakin said he would expect insurers to flee the exchanges even faster than they are under current policy, driving up premiums and forcing the federal government to increase subsidies to keep up with the skyrocketing rates.
The concern over how the change could create two separate pools of consumers, paying very different insurance rates, has prompted a group of more moderate rank-and-file senators to pitch a plan that they say would curb the risk of that sort of segmentation. Sen. Mike Rounds (R-S.D.) said he spoke with McConnell and Senate Majority Whip John Cornyn (R-Texas) Monday night in a private conversation on the Senate floor.
Rounds said he wants to create a fixed ratio between the least expensive plan and the most expensive plan that each company offers in a given state, though he did not offer details on how this goal would be achieved.